Nokea
The local health clinic recommends vaccination against influenza for all its employees. The influenza vaccine is given annually in:
- A. November
- B. December
- C. January
- D. February
Correct Answer: A
Rationale: Influenza vaccines are typically administered in November, before the peak flu season, to ensure immunity during winter months.
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The nurse is caring for an infant admitted from the delivery room. Which finding should be reported?
- A. Acyanosis
- B. Acrocyanosis
- C. Halequin sign
- D. Absent femoral pulses
Correct Answer: D
Rationale: Absent femoral pulses suggest coarctation of the aorta, a critical condition.
The doctor has ordered a patient-controlled analgesia (PCA) pump for the client with chronic pain. The client asks the nurse if he can become overdosed with pain medication using this machine. The nurse demonstrates understanding of the PCA if she states:
- A. The machine will administer only the amount that you need to control your pain without any action from you.'
- B. The machine has a locking device that prevents overdosing.'
- C. The machine will administer one large dose every 4 hours to relieve your pain.'
- D. The machine is set to deliver medication only if you need it.'
Correct Answer: B
Rationale: The PCA pump has a lockout mechanism to prevent overdosing, ensuring safe, patient-controlled dosing.
The nurse is teaching a client on the proper technique to use an inhaler with a spacer for asthma management. Which action by the client would require intervention by the nurse?
- A. The client shakes the unit vigorously 3 or 4 times.
- B. The client places the inhaler over his tongue and seals his lips tightly around it.
- C. The client administers the next puff immediately after exhaling.
- D. The client keeps his lips closed and holds his breath for at least 10 seconds before exhaling.
Correct Answer: B
Rationale: Placing the inhaler over the tongue obstructs the airway; lips should seal around the mouthpiece with the tongue underneath. Other actions are correct.
The nurse is instructing a client with iron-deficiency anemia. Which of the following meal plans would the nurse expect the client to select?
- A. Roast beef, gelatin salad, green beans, and peach pie
- B. Chicken salad sandwich, coleslaw, French fries, ice cream
- C. Egg salad on wheat bread, carrot sticks, lettuce salad, raisin pie
- D. Pork chop, creamed potatoes, corn, and coconut cake
Correct Answer: A
Rationale: Roast beef is a good source of heme iron, which is more easily absorbed, making this meal plan the best choice for a client with iron-deficiency anemia.
A student nurse overhears her instructor using the term pink puffer. The student knows this term refers to a client with which condition?
- A. chronic bronchitis
- B. chronic obstructive pulmonary disease (COPD)
- C. emphysema
- D. allergic asthma
Correct Answer: C
Rationale: Pink puffer' describes emphysema patients, who maintain oxygenation (pink) but hyperventilate (puffer) due to alveolar destruction.