Nokea
Spinal headaches are a common occurrence following spinal anesthesia. Which of the following nursing interventions can help prevent a spinal headache?
- A. Placing the client in a quiet room.
- B. Significantly increasing the client's fluid intake.
- C. Administering PRN pain medication.
- D. Raising the head of the bed to $45^{\circ}$.
Correct Answer: B
Rationale: Increasing fluid intake helps maintain cerebrospinal fluid pressure, reducing the risk of spinal headaches post-spinal anesthesia.
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The nurse prepares a client for discharge following a vasectomy. The client asks, 'When can I have sexual intercourse with my wife without using a condom?' What is the best response by the nurse?
- A. Discontinue alternative birth control after at least 5 ejaculations.
- B. There is no need to use alternative birth control following today's procedure.
- C. Use alternative birth control for 6 months following today's procedure.
- D. Use alternative birth control until your physician confirms the absence of sperm in a semen analysis.
Correct Answer: D
Rationale: A vasectomy requires confirmation of azoospermia via semen analysis, typically after 6-12 weeks or 15-20 ejaculations, to ensure sterility. Alternative birth control (C) is needed until this confirmation. Immediate unprotected intercourse (A) risks pregnancy, and 6 months (B) is unnecessarily long.
The clinic nurse cares for a 4-year-old who has been diagnosed with a pinworm infection. Which client symptom supports this diagnosis?
- A. Anal itching that is worse at night
- B. Intestinal bleeding with anemia
- C. Poor appetite with weight loss
- D. Red, scaly, blistered rings on skin
Correct Answer: A
Rationale: Pinworms cause anal itching, worse at night (A), due to female worms laying eggs. Bleeding (B), appetite loss (C), and skin lesions (D) are not typical, suggesting other conditions like hookworms or dermatitis.
A client is diagnosed as having secondary Cushing's syndrome. The nurse knows that the client has most likely been taking which medication?
- A. Estrogen
- B. Penicillin
- C. Lovastatin
- D. Prednisone
Correct Answer: D
Rationale: Secondary Cushing's syndrome is often caused by long-term prednisone use, a corticosteroid mimicking cortisol excess. Estrogen, penicillin, or lovastatin do not cause this condition.
The nurse has reinforced teaching about formula preparation with the parent of a newborn. Which of the following statements by the parent would indicate a correct understanding of the teaching? Select all that apply.
- A. I should avoid using the microwave to heat my baby's formula.
- B. I must wash the top of the concentrated formula can before opening it.
- C. If my baby is feeding poorly, I should use less water to dilute the formula.
- D. Prepared formula should be kept in the refrigerator and discarded after 24 hours.
- E. Bottled water does not need to be boiled when used to reconstitute powdered formula.
Correct Answer: A,B,D
Rationale: Microwaving (A) can cause uneven heating, risking burns, so it’s avoided. Washing the can top (B) prevents contamination. Refrigerated formula must be discarded after 24 hours (D) to prevent bacterial growth. Diluting less (C) alters nutrition, and bottled water (E) may need boiling depending on safety, indicating incorrect understanding.
A nurse discovers a cyanotic newborn with excessive frothy mucus in the mouth. What should be the nurse’s first action?
- A. Administer 100% oxygen
- B. Auscultate the lungs
- C. Place infant in knee-chest position
- D. Suction the infant’s mouth
Correct Answer: D
Rationale: Suctioning the mouth (D) clears mucus, addressing potential airway obstruction causing cyanosis. Oxygen (A), auscultation (B), and positioning (C) are secondary until the airway is clear.