Nokea
The health care provider has prescribed spironolactone to be given in addition to hydrochlorothiazide to a client with hypertension. Which finding by the nurse indicates that the spironolactone is having the desired effect?
- A. Blood glucose of 95 mg/dL (5.3 mmol/L)
- B. Potassium level of 4.2 mEq/L (4.2 mmol/L)
- C. Reduction in dizziness
- D. Sodium level of 138 mEq/L (138 mmol/L)
Correct Answer: B
Rationale: Spironolactone is a potassium-sparing diuretic, so a normal potassium level indicates it is counteracting the potassium loss from hydrochlorothiazide.
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Which of the following signs is highly suggestive of impaired hearing in an infant?
- A. The absence of the Moro reflex
- B. The absence of babbling by age 7 months
- C. A lack of eye contact when spoken to
- D. A lack of hand gesture to indicate wants
Correct Answer: B
Rationale: Absence of babbling by 7 months is a red flag for hearing impairment, as infants typically begin vocalizing in response to sounds. Other signs are less specific to hearing.
A client with a fracture of the radius had a plaster cast applied 2 days ago. The client complains of constant pain and swelling of the fingers. The first action of the nurse should be
- A. elevate the arm no higher than heart level
- B. remove the cast
- C. assess capillary refill of the exposed hand and fingers
- D. apply a warm soak to the hand
Correct Answer: C
Rationale: A deterioration in neurovascular status indicates the development of compartment syndrome (elevated tissue pressure within a confined area) which requires immediate pressure-reducing interventions.
A 1-year-old child who goes to day care is recovering from an episode of otitis media. Which intervention is most important for the nurse to reinforce to the parents in order to prevent recurrence?
- A. Exclusive breastfeeding
- B. Not sending the child to day care
- C. Preventing water from entering the ear
- D. Smoking cessation by the parents
Correct Answer: D
Rationale: Parental smoking increases the risk of recurrent otitis media due to secondhand smoke exposure.
The practical nurse (PN) is collaborating with the registered nurse to conduct a developmental assessment of a 9-month-old client during a well-child visit. Which statement by the infant's parent should cause the PN concern?
- A. Our child needs help to grasp and bring teething toys to the mouth.
- B. Our child says 'mamama' to our dog.
- C. Our child screams when approached by unfamiliar people.
- D. Our child uses both hands for support to be able to sit upright.
Correct Answer: A
Rationale: By 9 months, infants should independently grasp objects. This indicates a potential fine motor delay requiring further evaluation.
The nurse is discussing management of nocturnal enuresis with the parent of a 10-year-old client who has had little response to behavioral interventions. The parent tells the nurse, 'My child wants to go to overnight camp in several months but is afraid of being teased by other children if an accident occurs.' Which of the following responses would be most appropriate for the nurse to make?
- A. The condition will be resolved by then if you are consistent with bedtime routines.
- B. We can ask your child's health care provider about trying a medication that may be helpful.
- C. You could offer to send disposable training pants for your child to wear if needed.
- D. You should consider sending your child to day camp instead of overnight camp.
Correct Answer: B
Rationale: Medications like desmopressin may help manage enuresis for events like camp, addressing the child's concerns.