Nokea
Following an arteriogram, the nurse should give priority to:
- A. Allowing the client to rest
- B. Administering O2 via nasal mask
- C. Checking the ECG monitor
- D. Checking the pulses distal to the catheterization site
Correct Answer: D
Rationale: Checking distal pulses ensures adequate circulation post-arteriogram, as the procedure involves arterial puncture, which can lead to complications like hematoma or thrombosis.
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Laboratory reference ranges
Glucose (fasting)
Infant – Within 24 hours after birth
≥40 mg/dL (2.2 mmol/L)
The nurse is caring for assigned newborns. Which of the following newborns should the nurse check first?
- A. a newborn who was delivered 30 minutes ago and has bilateral crackles
- B. a newborn who was delivered 45 minutes ago and has asymmetric arm movement when the Moro reflex is tested
- C. a newborn who was delivered 6 hours ago and has a respiratory rate of 52/min
- D. a newborn who was delivered 12 hours ago, is jittery, and has a serum glucose level of 38 mg/dL (2.1 mmol/L)
Correct Answer: D
Rationale: A glucose level of 38 mg/dL with jitteriness (D) indicates hypoglycemia, a critical condition requiring immediate intervention. Crackles (A), asymmetric Moro reflex (B), and respiratory rate of 52 (C) are less urgent.
The nurse is discussing child safety with a group of mothers of toddlers. Which statement indicates a need for more instruction?
- A. My child should be in the back seat in a front-facing car seat.'
- B. My little one needs constant supervision.'
- C. My child eats finger foods.'
- D. I should put my medicines on a high shelf.'
Correct Answer: A
Rationale: Toddlers (under 2 years) should be in rear-facing car seats for safety; front-facing is incorrect, indicating a need for further instruction.
A woman has recently been diagnosed with multiple sclerosis. Which comment by the client indicates that she understands the nature of the disease process?
- A. I understand that recovery will be slow.'
- B. I am faithfully taking the medicines so the symptoms should disappear soon.'
- C. I will avoid being close to my grandchildren until I have been on medication for several months.'
- D. I bought a pretty cane to help me with balance when I am walking.'
Correct Answer: D
Rationale: Using a cane for balance shows understanding of multiple sclerosis' chronic, progressive nature causing mobility issues, unlike expecting full recovery or avoiding grandchildren.
The most important information for the nurse to have when planning care for the client with diabetes is the client's
- A. Family medical history
- B. Blood glucose history
- C. 24-hour dietary history
- D. Medical history
Correct Answer: B
Rationale: Answer B is correct. The most objective answer is the blood glucose history. Answers A, C, and D are more subjective. This information is reported data.
Which finding by the nurse suggests that the mother is not giving the toddler iron supplements as ordered?
- A. The child has pale skin.
- B. There is light brown stool in the diaper.
- C. The child takes a nap every day.
- D. The child has ecchymotic areas on her legs.
Correct Answer: B
Rationale: Iron supplements typically cause dark or black stools; light brown stools suggest non-compliance with iron supplementation.