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The 5-minute Apgar of a baby delivered by C-section is recorded as 9. The most likely reason for this score is:
- A. The mottled appearance of the trunk
- B. The presence of conjunctival hemorrhages
- C. Cyanosis of the hands and feet
- D. Respiratory rate of 20-28 per minute
Correct Answer: C
Rationale: A 5-minute Apgar score of 9 typically reflects one point deduction, often for color, with cyanosis of the hands and feet (acrocyanosis) being common in newborns, especially post-C-section, due to initial circulation adjustments. Mottling or hemorrhages don't directly score points off, and a respiratory rate of 20-28 is low (normal is 30-60), potentially docking more points. Nurses recognize acrocyanosis as benign, resolving naturally, and use this score to reassure parents while monitoring transition, ensuring no further intervention is needed.
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A healthcare provider is planning care for a client who has a latex allergy. Which of the following actions should the healthcare provider include in the plan?
- A. Use latex gloves with powder.
- B. Place a sign on the client's door.
- C. Apply oil-based lotion before donning gloves.
- D. Avoid using plastic equipment.
Correct Answer: B
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.
The nurse wants to check the popliteal pulse. This pulse can be better palpated if the nurse does which of the following things?
- A. Ask the client to extend the knee.
- B. Have the client flex the knee.
- C. Press lightly on the right side of the front of the knee.
- D. Palpate more deeply than for other pulses.
Correct Answer: B
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.
Before entering the room of a patient receiving treatment for Varicella, you must don personal protective equipment. Organize the correct sequence in how you will don personal protective equipment: Drag and Drop
- A. Don Gloves
- B. Don Gown
- C. Perform hand hygiene
- D. Don N95 Mask (respirator)
Correct Answer: C
Rationale: When donning personal protective equipment (PPE) for a patient with Varicella, which requires airborne precautions, the correct sequence ensures maximal protection and compliance with infection control standards. The proper order is: (1) Perform hand hygiene (C), (2) Don gown (B), (3) Don N95 mask (D), and (4) Don gloves (A). Hand hygiene comes first to remove contaminants from the hands, reducing the risk of transferring pathogens during PPE application. The gown is donned next to cover the body, followed by the N95 mask to protect against airborne particles, ensuring a tight seal. Gloves are applied last, extending over the gown cuffs to prevent exposure. Varicella, being highly contagious via airborne droplets, necessitates this meticulous sequence to safeguard the nurse. Incorrect ordering, like donning gloves before the gown, could leave gaps in protection or contaminate the gloves. The CSV format requires one correct answer, so C (perform hand hygiene) is selected as the critical first step, foundational to the entire process, aligning with CDC and WHO PPE protocols.
A healthcare provider is planning care for a client who has a pressure ulcer. Which of the following interventions should the healthcare provider include?
- A. Massage the ulcer
- B. Apply a heating pad
- C. Reposition the client every 2 hours
- D. Use alcohol-based cleansers
Correct Answer: C
Rationale: Repositioning the client every 2 hours is a crucial intervention in the management of pressure ulcers. This action helps redistribute pressure, reducing the risk of further skin breakdown and promoting wound healing. Massaging the ulcer can cause further damage to the skin and underlying tissues. Applying a heating pad can increase the risk of skin breakdown and should be avoided. Alcohol-based cleansers are too harsh for pressure ulcers and can irritate the skin, potentially delaying healing.
Which of the following statement is TRUE about professional boundaries?
- A. Allow personal relationships
- B. Maintain appropriate limits
- C. Only apply to patients
- D. All of the above
Correct Answer: B
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.