Nokea
Incidences of child abuse appear to be higher in the African-American community and might be explained by:
- A. the increased number of single-parent households in African-American communities
- B. more single-parent households in African-American communities
- C. stricter child-rearing practices in African-American households
- D. a higher occurrence of rage in African Americans
Correct Answer: B
Rationale: Child abuse is often associated with lower socioeconomic status and single-parent households due to increased stress and fewer support systems. Choice A is correct as single-parent households can face more challenges leading to a higher risk of child abuse. Choice B is the correct answer as it aligns with the risk factors associated with child abuse. Choice C is incorrect because there is no direct correlation between stricter child-rearing practices and child abuse rates. Choice D is incorrect because attributing child abuse to a higher occurrence of rage in African Americans is a stereotype and lacks evidence.
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The women's health charge nurse is making assignments for the next shift. The unit is short one staff member and will receive a nurse from the medical-surgical unit. Which group of clients should she assign to the medical-surgical nurse?
- A. Total abdominal hysterectomy, bladder suspension with A&P repair, client with breast reduction
- B. C-section planning discharge, post-partum infection, mastectomy
- C. Vaginal delivery of fetal demise, C-section with pneumonia, 32-week gestation with lymphoma
- D. 28-week gestation of bed rest, post-partum with HELLP syndrome, breast reconstruction
Correct Answer: A
Rationale: The correct answer includes clients who have undergone surgical procedures typically managed on a medical-surgical unit. Choice A consists of clients who have had elective surgical procedures such as hysterectomy, bladder suspension with A&P repair, and breast reduction, which are commonly treated in a medical-surgical setting. Choices B, C, and D involve clients with various complications related to childbirth, fetal demise, pneumonia, gestational lymphoma, HELLP syndrome, and bed rest, which are more complex cases requiring specialized care beyond medical-surgical nursing.
The client returns to the unit from surgery with a blood pressure of 90/50, pulse 132, respirations 30. Which action by the nurse should receive priority?
- A. Continue monitoring the vital signs
- B. Contact the physician
- C. Ask the client how they feel
- D. Ask the LPN to continue post-op care
Correct Answer: B
Rationale: The priority action for the nurse is to contact the physician immediately due to the client's abnormal vital signs. A blood pressure of 90/50, pulse of 132, and respirations of 30 indicate instability and require prompt medical attention. Continuing to monitor vital signs, as in choice A, may lead to a delay in necessary interventions. Asking the client how they feel, as in choice C, provides subjective data and does not address the urgent need for medical intervention. Involving the LPN, as in choice D, is not appropriate in this critical situation where the client's condition is unstable and requires immediate physician assessment and intervention.
When assessing a client for risk of hyperphosphatemia, which piece of information is most important for the nurse to obtain?
- A. A history of radiation treatment in the neck region
- B. A history of recent orthopedic surgery
- C. A history of minimal physical activity
- D. A history of the client's food intake
Correct Answer: A
Rationale: The correct answer is a history of radiation treatment in the neck region. Previous radiation to the neck may have damaged the parathyroid glands, which are crucial for calcium and phosphorus regulation. This damage can lead to disruptions in phosphorus levels, increasing the risk of hyperphosphatemia. Choices B, C, and D are not as directly related to phosphorus regulation. Orthopedic surgery, minimal physical activity, and food intake are more closely associated with calcium levels rather than phosphorus regulation. Therefore, it is essential for the nurse to focus on obtaining information about a history of radiation treatment in the neck region when assessing the risk of hyperphosphatemia in a client.
During a school screening, a nurse notices small bruises on the anterior and posterior ribs of an 8-year-old Asian child. The nurse should ask the child:
- A. if the family practices coining
- B. who performs coinings
- C. if the child has fallen
- D. how long the child has been abused
Correct Answer: A
Rationale: The correct answer is to ask if the family practices coining. In Asian cultures, coining is a traditional practice believed to draw infections from the body. It involves rubbing a heated coin on the chest and torso, which can cause bruising similar to what the nurse noticed on the child's ribs. This question is important to differentiate between cultural practices and potential child abuse. Choices B, C, and D are incorrect because assuming abuse without considering cultural practices can lead to misinterpretation and inappropriate actions. It's crucial for healthcare providers to be culturally sensitive and gather all relevant information before making conclusions.
Which action by the novice nurse indicates a need for further teaching?
- A. The nurse fails to wear gloves when removing a dressing.
- B. The nurse applies an oxygen saturation monitor to the earlobe.
- C. The nurse elevates the head of the bed to check blood pressure.
- D. The nurse places the extremity in a dependent position to acquire a peripheral blood sample.
Correct Answer: A
Rationale: The correct answer is A. The novice nurse failing to wear gloves when removing a dressing indicates a need for further teaching to emphasize infection control practices. This action can lead to the spread of infections. Choices B, C, and D are incorrect because they demonstrate proper nursing skills and techniques. Applying an oxygen saturation monitor to the earlobe, elevating the head of the bed to check blood pressure, and placing the extremity in a dependent position to acquire a peripheral blood sample all reflect understanding of correct procedures in patient care.