Nokea
A tour bus has overturned on an exit ramp. Many passengers are injured, but there are no fatalities. While the emergency department nurse prepares for treating the injured, the nurse also calls the crisis nurse based on the understanding about which of the following?
- A. The accident victims will be experiencing grief and mourning.
- B. Many of the passengers may be experiencing feelings of victimization.
- C. There is a need for someone to coordinate calls from relatives about the passengers.
- D. Some of the passengers will need psychiatric hospitalization.
Correct Answer: B
Rationale: A crisis nurse can address feelings of victimization, a common psychological response to traumatic accidents, providing emotional support.
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Which intervention would you expect to render to the client in a sickle cell anemia crisis?
- A. The administration of a thrombolytic medication
- B. The administration of hydroxyurea
- C. Placing the client in the Trendelenburg position
- D. Placing the client in the lithotomy position
Correct Answer: B
Rationale: Hydroxyurea is used in sickle cell anemia to reduce the frequency of crises by increasing fetal hemoglobin, which helps prevent sickling of red blood cells.
While assessing the psychosocial aspects of a primigravid client at 30 weeks' gestation, which of the following feelings are expected?
- A. Vulnerability.
- B. Confirmation.
- C. Ambivalence.
- D. Body image disturbance.
Correct Answer: C
Rationale: Ambivalence is common in pregnancy, reflecting mixed emotions about impending motherhood and life changes.
The nurse is caring for a client with a history of venous thromboembolism who is prescribed rivaroxaban (Xarelto). The nurse should instruct the client to report which of the following side effects immediately?
- A. Mild bruising.
- B. Bleeding gums.
- C. Headache.
- D. Nausea.
Correct Answer: B
Rationale: Bleeding gums indicate a potential bleeding complication with rivaroxaban, requiring immediate reporting.
Which is an intrinsic risk factor that places the client at risk for pressure ulcers?
- A. Pressure
- B. Shearing
- C. Impaired tissue perfusion
- D. Friction
Correct Answer: C
Rationale: Impaired tissue perfusion is an intrinsic risk factor for pressure ulcers, as it reduces oxygen and nutrient delivery to tissues, increasing susceptibility to breakdown.
A client who is brought to the emergency department has experienced a burn covering greater than 25% of his total body surface area (TBSA). When reviewing the laboratory results drawn on the client, which value should the nurse most likely expect to note?
- A. Hematocrit 65% (0.65)
- B. Albumin 4.0 g/dL (40 g/L)
- C. Sodium 140 mEq/L (140 mmol/L)
- D. White blood cell (WBC) count 6000 mm^3 (6 x 10^9/L)
Correct Answer: A
Rationale: Extensive burns covering greater than 25% of the TBSA result in generalized body edema in both burned and nonburned tissues and a decrease in circulating intravascular blood volume. Hematocrit levels elevate in the first 24 hours after injury (the emergent phase) as a result of hemoconcentration from the loss of intravascular fluid. The normal hematocrit is 42 to 52% (0.42-0.52) in the male and 37 to 47% (0.37-0.47) in the female. The normal albumin is 3.5-5 g/dL (35-50 g/L). The normal sodium level is 135 to 145 mEq/L (135-145 mmol/L). The normal WBC count is 5000 to 10,000 mm^3 (5-10 x 10^9/L).