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The emergency department nurse is working in a community hospital. During the past two (2) hours, 15 clients have been admitted with Salmonella food poisoning. Which information should the nurse discuss with the clients?
- A. Explain the incubation period is 48 to 72 hours.
- B. Explain the source of this poisoning is contaminated water.
- C. Explain the sources of contamination are eggs and chicken.
- D. Explain the bacterial contaminant came from canned foods.
Correct Answer: C
Rationale: Salmonella is commonly associated with undercooked eggs and poultry, making this the most accurate information. Incubation is 6–72 hours, water is less common, and canned foods are linked to botulism.
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The client is being admitted to the outpatient psychiatric clinic diagnosed with bulimia. Which question should the nurse ask to identify behaviors suggesting bulimia?
- A. When was the last time you exercised?
- B. What over-the-counter medications do you take?
- C. How long have you had a positive self-image?
- D. Do you eat a lot of high-fiber foods for bowel movements?
Correct Answer: B
Rationale: Asking about OTC medications identifies purging behaviors (e.g., laxatives, diuretics) common in bulimia. Exercise, self-image, and fiber intake are less specific.
The parents of a female toddler bring the child to the pediatrician's office with nausea, vomiting, and diarrhea. Which intervention should the nurse implement first?
- A. Ask the parent about the child's diet.
- B. Assess the child's tissue turgor.
- C. Give the child a sucker if she is good.
- D. Notify the HCP the child is waiting to be seen.
Correct Answer: B
Rationale: Assessing tissue turgor evaluates dehydration, a priority in a toddler with vomiting and diarrhea. Diet history, rewards, and HCP notification follow assessment.
The nurse is caring for the client who is 6 hours post—open cholecystectomy. The client's T—tube drainage bag is empty, and the nurse notes slight jaundice of the sclera. Which action by the nurse is most important?
- A. Reposition the client to promote T-tube drainage
- B. Telephone the surgeon to report these findings
- C. Ask a nursing assistant to obtain a blood pressure
- D. Record the findings and continue to monitor the client
Correct Answer: B
Rationale: A. Repositioning the client might promote bile flow into the T—tube if the client were lying on the tube. However, the jaundice indicates that the problem is internal. B. The T-tube is placed in the common bile duct to ensure patency of the duct. Lack of bile draining into the T—tube and jaundiced sclera are signs of an obstruction to the bile flow. This is most important to report to the surgeon. C. The client’s BP would not be affected by this situation. D. Recording the findings and continuing to monitor the client are inappropriate because the client is experiencing signs of a complication.
The client diagnosed with chronic pancreatitis is concerned about pain control. The nurse explains that the initial plan for chronic pancreatic pain control involves the administration of which of the following?
- A. Opioid analgesics, such as morphine sulfate
- B. Nonsteroidal anti-inflammatory drugs (NSAIDs)
- C. Pancreatic enzymes with H2 blocker medications
- D. Injection of medication directly into the nerves
Correct Answer: C
Rationale: A. Opioid analgesics may be prescribed if pancreatic enzymes do not relieve pain. B. NSAIDs, such as ibuprofen, may be used to treat chronic pancreatic pain, but they are not the initial treatment and are usually not sufficient to control the pain. C. The initial pain control measures include exogenous pancreatic enzymes because pancreatic stimulation by food is thought to cause pain. Pancreatic enzymes are coupled with H2 blockers, which block the action of histamine on parietal cells in the stomach. H2 blockers are used because gastric acid destroys the lipase needed to break down fats. D. A nerve block relieves pain in about 50 percent of people who undergo the procedure, but this is not the initial measure for pain control.
Which nursing interventions should be included in the care plan for the 84-year-old client diagnosed with acute gastroenteritis?
- A. Assess the skin turgor on the back of the client’s hands.
- B. Monitor the client for orthostatic hypotension.
- C. Record the frequency and characteristics of sputum.
- D. Use Standard Precautions when caring for the client.
- E. Institute safety precautions when ambulating the client.
Correct Answer: A,B,D,E
Rationale: Assessing skin turgor and orthostatic hypotension monitors dehydration, Standard Precautions prevent spread, and safety precautions address weakness in the elderly. Sputum is unrelated to gastroenteritis.