Nokea
The client has expired secondary to smallpox. Which information about funeral arrangements is most important for the nurse to provide to the client’s family?
- A. The client should be cremated.
- B. Suggest an open casket funeral.
- C. Bury the client within 24 hours.
- D. Notify the public health department.
Correct Answer: D
Rationale: Notifying the public health department is critical for smallpox, a highly contagious disease, to ensure containment. Cremation, open caskets, and rapid burial are secondary.
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The client is admitted into the emergency department with diaphoresis, pale clammy skin, and BP of 90/70. Which intervention should the nurse implement first?
- A. Start an IV with an 18-gauge catheter.
- B. Administer dopamine intravenous infusion.
- C. Obtain arterial blood gases (ABGs).
- D. Insert an indwelling urinary catheter.
Correct Answer: A
Rationale: Hypovolemic shock (suggested by symptoms) requires immediate IV access for fluid resuscitation. Dopamine requires IV access, ABGs are diagnostic, and urinary catheter monitors output but is secondary.
Which statement explains the scientific rationale for having emergency suction equipment available during resuscitation efforts?
- A. Gastric distention can occur as a result of ventilation.
- B. It is needed to assist when intubating the client.
- C. This equipment will ensure a patent airway.
- D. It keeps the vomitus away from the healthcare provider.
Correct Answer: C
Rationale: Suction equipment clears vomit or secretions, ensuring a patent airway during resuscitation. Gastric distention, intubation, and HCP protection are secondary concerns.
Which problem is most appropriate for the nurse to identify for the client experiencing renal trauma?
- A. Infection of the renal tract.
- B. Ineffective tissue perfusion.
- C. Alteration in skin integrity.
- D. Alteration in temperature.
Correct Answer: B
Rationale: Renal trauma risks bleeding and hypoperfusion, making ineffective tissue perfusion the primary problem. Infection, skin integrity, and temperature are less immediate.
The client is diagnosed with neurogenic shock. Which signs/symptoms should the nurse assess in this client?
- A. Cool, moist skin.
- B. Bradycardia.
- C. Wheezing.
- D. Decreased bowel sounds.
Correct Answer: B
Rationale: Neurogenic shock causes bradycardia due to loss of sympathetic tone. Cool, moist skin is typical of hypovolemic shock, wheezing suggests anaphylaxis, and decreased bowel sounds are non-specific.
The charge nurse has been notified that a disaster has occurred and that all possible clients should be discharged so the floor can receive the casualties. Which client should not be discharged?
- A. The 13-year-old client who is scheduled for a tonsillectomy.
- B. The 42-year-old client scheduled for an abdominal aorta aneurysm dissection.
- C. The 76-year-old client diagnosed with a pulmonary embolus whose INR is 2.9.
- D. The 80-year-old client who is refusing to assist in activities of daily living.
Correct Answer: C
Rationale: A pulmonary embolus with INR 2.9 (therapeutic) requires ongoing anticoagulation and monitoring, precluding discharge. Tonsillectomy, aneurysm surgery, and ADL refusal are less acute.