Nokea
Ideally, the first dose of what vaccine is given at birth?
- A. IPV
- B. Hib
- C. DTaP
- D. hepatitis B
Correct Answer: D
Rationale: The hepatitis B vaccine is recommended at birth to prevent perinatal transmission and establish early immunity.
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A client diagnosed with lung cancer asks the nurse what the term MO refers to. The nurse says that MO means
- A. no distant metastasis present.
- B. distant metastasis present.
- C. distant metastasis cannot be evaluated.
- D. metastasis present only in immediate lymph nodes.
Correct Answer: A
Rationale: In cancer staging, M0 indicates no distant metastasis, per TNM classification.
The nurse is talking to a client and his family about hepatitis. Which of the following statements by a family member indicate understanding of the nurse's teaching? Select all that apply.
- A. Hepatitis D only occurs with hepatitis B.
- B. Hepatitis A can occur at any time of the year.
- C. Hepatitis D is transmitted through contaminated drinking water.
- D. Hepatitis A can be spread by uncooked shellfish and contaminated water or milk.
- E. Hepatitis B is spread by contact with blood or body fluids, sexual contact, or sharing dirty needles.
Correct Answer: A, B, D, E
Rationale: Hepatitis D requires hepatitis B, hepatitis A is year-round and spread via contaminated food/water, and hepatitis B is transmitted through blood/body fluids. Hepatitis D is not waterborne.
The nurse is caring for a newborn who is on strict intake and output. The used diaper weighs $73.5 \mathrm{gm}$. The diaper's dry weight was $62 \mathrm{gm}$. The newborn's urine output is:
- A. 10 ml
- B. 11.5 ml
- C. 10 gm
- D. 12 gm
Correct Answer: B
Rationale: Urine output is calculated by subtracting dry diaper weight from wet diaper weight: 73.5 gm - 62 gm = 11.5 ml (1 gm = 1 ml for urine).
The nurse is assessing a client for hypovolemia. Which laboratory result would help the nurse in confirming a volume deficit?
- A. Hematocrit 55%
- B. Potassium 5.0 mEq/L
- C. Urine specific gravity 1.016
- D. BUN 18 mg/dL
Correct Answer: A
Rationale: Hypovolemia causes hemoconcentration, increasing hematocrit (e.g., 55% is elevated). Potassium, urine specific gravity, and BUN within normal ranges don't confirm volume deficit.
A nurse on the orthopedics floor is asked by another nurse to witness her waste 1 mg of morphine. The nurse draws the full 2 mg dose of morphine into the syringe and tells the first nurse, 'This client does not get enough pain relief with 1 mg of morphine, so I just go ahead and give 2 mg to keep him comfortable because the doctor won't change the dose.' Which is the correct action by the first nurse?
- A. tell the other nurse to call the doctor back and request an increase in the dosage
- B. refuse to sign off on the waste and report the incident to the charge nurse or unit manager
- C. sign off the waste, and suggest that the nurse give it over two separate doses 30 minutes apart
- D. sign off the waste, but tell the nurse to give it slowly to be sure that the client can tolerate the dose
Correct Answer: B
Rationale: Administering an unordered dose is a medication error and potential diversion. Refusing to sign and reporting ensures patient safety and accountability.