Nokea
According to Erikson's stages of physical development, school-age children 5 - 12 years old typically face which psychological crisis?
- A. ego integrity versus despair
- B. industry versus inferiority
- C. trust versus mistrust
- D. ego identity versus role confusion
Correct Answer: B
Rationale: School-age children (5-12) face industry vs. inferiority, focusing on developing competence and self-esteem through tasks and skills.
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A client in the ICU is given procainamide HCl (Pronestyl) slowly IV push. The nurse should withhold the next dose of this medication and notify the physician if which of the following is observed on the cardiac monitor?
- A. One premature ventricular contraction (PVC).
- B. Sinus rhythm with occasional bigeminy.
- C. Persistent tachycardia of 112 beats per minute.
- D. Prolongation of the QT interval.
Correct Answer: D
Rationale: prolongation of the QT interval is a side effect that can lead to torsades de pointes, a life-threatening arrhythmia
The nurse is caring for a client with bipolar disorder. The client has been manipulating some of the staff and other clients in order to get her way. Which actions by the nurse are appropriate in managing this client? Select all that apply.
- A. giving support when the client exhibits positive behaviors
- B. setting clear limits and communicating expected behaviors
- C. role playing with the client to demonstrate appropriate behaviors
- D. treating the client more like a friend in order to show respect for her as a person
- E. giving the client small gifts, such as extra dessert, in order to encourage appropriate behavior
Correct Answer: A,B,C
Rationale: Appropriate actions include reinforcing positive behaviors (A), setting clear limits (B), and role-playing (C) to promote appropriate interactions. Treating as a friend (D) or giving gifts (E) blurs boundaries and encourages manipulation.
An obstetric client is admitted with dehydration. Which IV fluid would be most appropriate for the client?
- A. .45 normal saline
- B. Dextrose 1% in water
- C. Lactated Ringer's
- D. Dextrose 5% in .45 normal saline
Correct Answer: C
Rationale: Lactated Ringer's is isotonic and effective for correcting dehydration in obstetric clients, replacing fluids and electrolytes.
The nurse is preparing to deliver an infusion of vancomycin through a client's peripherally inserted central catheter (PICC). Shortly after the infusion begins the IV pumps beeps, indicating a blockage. How should the nurse proceed? Select all that apply.
- A. start a peripheral IV in the opposite limb
- B. notify the PICC nurse if unable to clear the blockage
- C. use a 5 mL syringe to flush the PICC with sterile saline
- D. ask the client to raise and lower the arm or cough
- E. attempt to flush the line by aggressively pushing heparin to clear the blockage
- F. use a 10 mL syringe to gently flush the PICC with sterile saline or tPA as ordered
Correct Answer: B, D, F
Rationale: Notifying the PICC nurse, repositioning the arm, and gently flushing with a 10 mL syringe (saline or tPA as ordered) are appropriate. Aggressive flushing or small syringes risk damage, and a peripheral IV is unnecessary.
A preterm infant with sepsis is receiving Gentamycin (garamycin). Which physiological alteration places the preterm infant at increased risk for toxicity related to aminoglycoside therapy?
- A. Lack of subcutaneous fat deposits
- B. Immature central nervous system
- C. Presence of fetal hemoglobin
- D. Immaturity of the renal system
Correct Answer: D
Rationale: The immature renal system in preterm infants reduces the ability to excrete aminoglycosides like Gentamycin, increasing the risk of toxicity.