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An electrical fire occurs in a client's room shortly after the client returns from the recovery room after repair of a hip fracture with insertion of a prosthesis. What is the best method of removing the client from the room?
- A. Place the client in a wheelchair.
- B. Transfer the client to a gurney.
- C. Move the bed with the client on it.
- D. Do a two-person carry.
Correct Answer: C
Rationale: Moving the bed with the client on it (C) is the safest and fastest method to evacuate a post-surgical client with limited mobility during an emergency like a fire. Other methods (A, B, D) risk injury or delay.
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The nurse is caring for a client with a tracheostomy tube in place. During tracheostomy care, the nurse accidentally dislodges the tube. Which of the following actions should the nurse take FIRST?
- A. Insert a new tracheostomy tube immediately.
- B. Call for assistance from the respiratory therapist.
- C. Attempt to reinsert the dislodged tube.
- D. Cover the stoma with a sterile dressing.
Correct Answer: A
Rationale: immediate reinsertion of a tracheostomy tube is critical to maintain airway patency
The nurse is talking in the lounge with other nurses about grief and loss. The nurse understands which to be true regarding grief and loss? Select all that apply.
- A. The process of grief is detrimental to physical and emotional health.
- B. Age, gender, and culture are a few factors that influence the grieving process.
- C. The nurse must explore his own feelings about death before he may effectively help others.
- D. The nurse should discourage expression of grief and loss because it may upset other clients nearby.
- E. The nurse can help the family develop ways to relieve loneliness and depression following the death of a loved one.
Correct Answer: B, C, E
Rationale: Age, gender, and culture influence grief; nurses must process their own feelings to help others, and supporting families post-loss is key. Grief is not inherently detrimental, and expression should be encouraged.
A 20-year-old male has recently been diagnosed with schizophrenia. The nurse knows which of the following are classic signs and symptoms of this disorder? Select all that apply.
- A. social withdrawal
- B. agitation
- C. auditory hallucinations
- D. disorganized speech
- E. obsession with personal hygiene
Correct Answer: A,C,D
Rationale: Schizophrenia symptoms include social withdrawal, auditory hallucinations, and disorganized speech. Agitation may occur but is less specific, and obsession with hygiene is not typical.
The nurse is preparing to administer a dose of prednisone (Deltasone) to a client with rheumatoid arthritis. The client asks, “Why do I need to take this medication?” Which of the following responses by the nurse is correct?
- A. It helps reduce inflammation and joint pain.
- B. It prevents infections in your joints.
- C. It increases calcium absorption in your bones.
- D. It promotes muscle strength.
Correct Answer: A
Rationale: prednisone is a corticosteroid that reduces inflammation and pain in rheumatoid arthritis
The client has an order for gentamycin to be administered. Which lab results should be reported to the doctor before beginning the medication?
- A. Hematocrit
- B. Creatinine
- C. White blood cell count
- D. Erythrocyte count
Correct Answer: B
Rationale: Creatinine levels indicate renal function, critical to monitor before administering gentamycin, which is nephrotoxic.