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A physician is calling the pediatric unit and asking the nurse to go into the electronic medical record (EMR) for test results of a fellow pediatrician. How should the nurse respond to this request?
- A. Identify if the calling physician is the physician of record or has a need to know.
- B. Access the EMR and give the physician the test results.
- C. Decline to give the physician the information requested.
- D. Determine whether the nurse can access the EMR.
Correct Answer: A
Rationale: Verifying the physician's need to know ensures compliance with privacy regulations (e.g., HIPAA) before sharing EMR data, protecting patient confidentiality.
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A client with a fractured femur is placed in skeletal traction. The nurse should assess the client for which of the following complications?
- A. Pressure ulcers.
- B. Deep vein thrombosis.
- C. Hypovolemia.
- D. Infection at the pin sites.
Correct Answer: B,D
Rationale: Skeletal traction increases the risk of deep vein thrombosis due to immobility and infection at pin sites due to skin penetration.
A child with partial- and full-thickness burns is admitted to the pediatric unit. Which of the following should be the priority at this time?
- A. Preventing wound infection.
- B. Evaluating vital signs frequently.
- C. Maintaining fluid and electrolyte balance.
- D. Managing the child's pain.
Correct Answer: C
Rationale: Maintaining fluid and electrolyte balance is the priority in burn care to prevent hypovolemic shock due to significant fluid loss.
A client is being treated with I.V. fluids for hypovolemic shock. Which of the following values is the best indicator that fluid resuscitation has been effective?
- A. Urine output of 30 mL/hour.
- B. Systolic blood pressure of 90 mm Hg.
- C. Respiratory rate of 22 breaths/minute.
- D. Pulse rate of 110 bpm.
Correct Answer: A
Rationale: A urine output of 30 mL/hour indicates adequate renal perfusion, a key sign of effective fluid resuscitation in hypovolemic shock.
A nulligravid client calls the clinic and tells the nurse that she forgot to take her oral contraceptive in the morning. Which of the following should the nurse instruct the client to do?
- A. Take the medication immediately.
- B. Restart the medication in the morning.
- C. Use another form of contraception for 2 weeks.
- D. Take two pills tonight before bedtime.
Correct Answer: A
Rationale: Taking the missed pill immediately maintains hormonal levels, minimizing the risk of ovulation. Additional contraception may be needed if more doses are missed.
An adolescent is being prepared for an emergency appendectomy. The nurse should tell the client? Select all that apply.
- A. Friends can visit whenever they want.
- B. The scar will be small.
- C. The teen will be back in school in 1 week.
- D. Antibiotics will be given to prevent an infection.
- E. A dressing will stay in place for 1 week.
Correct Answer: B,C,D
Rationale: A small scar, school return in about a week, and prophylactic antibiotics are accurate expectations for appendectomy recovery. Unrestricted visits and prolonged dressing use are incorrect.