Nokea
The emergency room nurse admits a child who experienced a seizure at school. The parent comments that this is the first occurrence and denies any family history of epilepsy. What is the best response by the nurse?
- A. Do not worry. Epilepsy can be treated with medications.
- B. The seizure may or may not mean your child has epilepsy.
- C. Since this was the first convulsion, it may not happen again.
- D. Long term treatment will prevent future seizures.
Correct Answer: B
Rationale: The seizure may or may not mean your child has epilepsy. A single seizure has multiple potential causes, not necessarily epilepsy.
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A person who has psoriasis is seen in the clinic. The lesions are covered with coal tar. Which instruction should the nurse give the client?
- A. Call if you have nausea and vomiting.'
- B. Protect the area from sunlight for 24 hours.'
- C. Wash off the solution after six to eight hours.'
- D. Call if your skin looks dark during the treatment.'
Correct Answer: B
Rationale: Coal tar increases photosensitivity; protecting the area from sunlight for 24 hours prevents burns. Nausea, washing off, or skin darkening are not primary concerns.
A client arrives at the clinic for a follow-up after an emergency department visit the night before. The client sustained an ulnar fracture, and a fiberglass cast was applied. Which of the following teachings related to cast care should the nurse reinforce? Select all that apply.
- A. Contact the clinic if any hot areas or foul odors develop in the cast
- B. Cover the cast with a plastic bag for bathing, and avoid getting the cast wet
- C. Elevate the affected extremity above heart level for the first 48 hours
- D. Expect some numbness and tingling of the fingers during the first week
- E. Use only soft, padded objects to scratch the skin under the cast
Correct Answer: A,B,C,E
Rationale: Hot areas or odors (A) suggest infection, keeping the cast dry (B) prevents skin breakdown, elevation (C) reduces swelling, and soft objects (E) avoid injury. Numbness and tingling (D) are not normal and may indicate nerve compression, requiring immediate reporting.
The nurse is preparing a client for a magnetic resonance cholangiopancreatography. Which statements by the client would require the nurse to obtain further assessment data? Select all that apply.
- A. I ate lunch about 4 or 5 hours ago.
- B. I got a rash the last time I had IV contrast.
- C. I had my last period 6 weeks ago.
- D. I have a hearing aid implanted in my ear.
- E. I smoked a cigarette about an hour ago.
Correct Answer: B,C,D
Rationale: A contrast allergy rash (B) requires premedication or alternative imaging. A possible pregnancy (C) needs confirmation due to MRI risks. A hearing aid implant (D) may be MRI-incompatible. Recent eating (A) is less critical unless sedation is planned, and smoking (E) is irrelevant.
A low-residue diet is ordered for an adult. The nurse knows that the client understands the diet when which menu is selected?
- A. Lettuce and tomato salad, steak sandwich, orange slices
- B. Gelatin salad, mashed potatoes, sliced chicken
- C. Corn casserole, pork chop, rice
- D. Broccoli, broiled fish, sesame seed roll
Correct Answer: B
Rationale: Gelatin, mashed potatoes, and sliced chicken are low-fiber, low-residue foods, suitable for the diet. Lettuce, corn, broccoli, and sesame seeds are high-fiber, increasing residue.
A mother noticed a large abdominal mass when helping her 3-year-old child bathe. The child is taken to the physician and admitted to the hospital after an intravenous pyelogram (IVP) confirms the diagnosis of Wilms' tumor. Which nursing action is essential to include in the nursing care plan?
- A. Strain all urine and save for analysis.
- B. Avoid palpating the abdomen.
- C. Prepare the child for permanent dialysis.
- D. Help the family understand the poor prognosis.
Correct Answer: B
Rationale: Avoiding abdominal palpation prevents potential tumor rupture or metastasis in Wilms' tumor, a critical precaution. Urine straining, dialysis, or poor prognosis are inappropriate.