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A nurse is working in a residential facility when a fire breaks out in one hallway. The nurse and an elderly client are trapped in the client's room and cannot get out. The nurse should
- A. crawl in the closet with the client and shut the door.
- B. open a window in the client's room.
- C. instruct the client to crawl under the bed.
- D. leave the door to the room open.
Correct Answer: B
Rationale: Opening a window provides ventilation and a potential escape route while avoiding smoke inhalation. Keeping the door closed prevents smoke entry, and crawling under the bed or in a closet is unsafe.
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Ideally, the first dose of what vaccine is given at birth?
- A. IPV
- B. Hib
- C. DTaP
- D. hepatitis B
Correct Answer: D
Rationale: The hepatitis B vaccine is recommended at birth to prevent perinatal transmission and establish early immunity.
Which of the following is NOT a component of evidence-based practice?
- A. outcomes of research studies
- B. culturally competent care
- C. patient values
- D. clinical expertise
Correct Answer: B
Rationale: Evidence-based practice integrates research outcomes, patient values, and clinical expertise. Culturally competent care is important but not a core component of EBP.
A client with obsessive compulsive personality disorder annoys his coworkers with his rigid-perfectionistic attitude and his preoccupation with trivial details. An important nursing intervention for this client would be:
- A. Helping the client develop a plan for changing his behavior
- B. Contracting with him for the time he spends on a task
- C. Avoiding a discussion of his annoying behavior because it will only make him worse
- D. Encouraging him to set a time schedule and deadlines for himself
Correct Answer: D
Rationale: Setting a time schedule helps the client manage perfectionistic tendencies by structuring tasks, reducing preoccupation with trivial details.
A client undergoing 'cold-turkey' withdrawal from years of substance abuse is most at risk of serious life-threatening complications with which of the following substances?
- A. Heroin.
- B. Cocaine.
- C. Alcohol.
- D. Marijuana.
Correct Answer: C
Rationale: Alcohol withdrawal (C) can cause life-threatening complications like seizures and delirium tremens. Heroin (A), cocaine (B), and marijuana (D) withdrawal, while uncomfortable, are less likely to be fatal.
A client has suffered a severe electrical burn. Which medication would the nurse expect to have ordered for application to the burned area?
- A. Mafenide acetate (Sulfamylon)
- B. Silver nitrate
- C. Providone-iodine ointment
- D. Silver sulfadiazine (Silvadene)
Correct Answer: D
Rationale: Silver sulfadiazine (Silvadene) is commonly used for electrical burns due to its broad-spectrum antimicrobial properties and soothing effect on burn wounds.