Nokea
A nurse notes that clients of one surgeon have developed at least twice as many infections as clients of other surgeons on the unit. Which of the following is the most appropriate action?
- A. Report the physician to the hospital administration.
- B. Ask the physician why his rate of infections is so high.
- C. Report the observations to the infection control nurse.
- D. Say nothing as infection rates vary from time to time.
Correct Answer: C
Rationale: Reporting to the infection control nurse (C) initiates investigation and intervention. Reporting to administration (A) or confronting the physician (B) is premature, and ignoring the issue (D) is unsafe.
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A client's lab results have just come in. The nurse reviews the electrolytes and contacts the health care provider regarding which result?
- A. chloride 167 mEq/L
- B. calcium 9.3 mg/dL
- C. phosphate 3.8 mg/dL
- D. sodium 141 mEq/L
Correct Answer: A
Rationale: Chloride 167 mEq/L is severely elevated (normal 98-106 mEq/L), requiring immediate attention. Other values are normal.
A client diagnosed with tuberculosis asks the nurse when he can return to work. The nurse should tell the client that:
- A. He can return to work when he has three negative sputum cultures.
- B. He can return to work as soon as he feels well enough.
- C. He can return to work after a week of being on the medication.
- D. He should think about applying for disability because he will no longer be able to work.
Correct Answer: A
Rationale: Three negative sputum cultures indicate the client is no longer contagious, allowing safe return to work after tuberculosis treatment.
A client is admitted with a blood alcohol level of 180 mg/dL. The nurse recognizes that the alcohol in the client's system should be fully metabolized within:
- A. 3 hours
- B. 5 hours
- C. 7 hours
- D. 9 hours
Correct Answer: D
Rationale: A blood alcohol level of 180 mg/dL (0.18%) typically takes about 9 hours to metabolize, assuming a metabolism rate of 0.02% per hour.
The nurse is caring for an 11-year-old patient being treated for a fractured right femur with balanced suspension traction with a Thomas splint and Pearson attachment. The nurse notes that the patient’s left leg is externally rotated. The nurse should
- A. place a trochanter roll on the outer aspect of the thigh.
- B. perform resistive range of motion of the left leg.
- C. adduct and internally rotate the left leg.
- D. instruct the patient to maintain the left leg in a neutral position.
Correct Answer: A
Rationale: holds hip in neutral position and leg in normal alignment, entire weight of leg cannot be held by props placed below knee
Intra-arterial chemotherapy primarily benefits the client by applying greater concentrations of medication directly to the malignant tumor. An additional benefit of intra-arterial chemotherapy is:
- A. Prevention of nausea and vomiting
- B. Treatment of micro-metastasis
- C. Eradication of bone pain
- D. Prevention of therapy-induced anemia
Correct Answer: B
Rationale: Intra-arterial chemotherapy can treat micro-metastases by delivering high drug concentrations to the tumor and surrounding areas.