Nokea
The local health clinic recommends vaccination against influenza for all its employees. The influenza vaccine is usually 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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A pregnant client continues to visit the clinic regularly during her pregnancy. During one of her visits while lying supine on the examining table, she tells the RN that she is becoming light-headed. The RN notices that the client has pallor in her face and is perspiring profusely. The first intervention the RN should initiate is to:
- A. Place the examining table in the Trendelenburg position
- B. Assess the client to see if she is having vaginal bleeding
- C. Obtain the client's vital signs immediately
- D. Help the client to a sitting position
Correct Answer: D
Rationale: This position would cause the gravid uterus to bear the increased pressure of the vena cava, which could lead to maternal hypotension, in turn causing the client to continue to have pallor and to feel light-headed. This would not be the first intervention the RN should initiate. The RN should understand the supine position and its effect on the gravid uterus and vena cava. The RN's first intervention should be one that helps to alleviate the client's symptoms. Obtaining her vital signs will not alleviate her symptoms. This would move the gravid uterus off of the client's vena cava, which would alleviate the maternal hypotension that is the cause of her symptoms.
A client with a history of a stroke is being taught to use a cane. The nurse should teach the client to:
- A. Hold the cane in the strong hand
- B. Advance the cane with the strong leg
- C. Use the cane on the weak side
- D. Lean heavily on the cane while walking
Correct Answer: C
Rationale: The cane should be used on the weak side to support the affected leg, improving balance and gait post-stroke. Holding it in the strong hand or advancing with the strong leg is incorrect.
The nurse is caring for a client with a chest tube. Which observation requires immediate intervention?
- A. The water seal chamber is bubbling continuously.
- B. The drainage system is positioned below the client’s chest.
- C. The chest tube is taped securely to the chest.
- D. The client is lying on the affected side.
Correct Answer: D
Rationale: Lying on the affected side can compress the chest tube, obstructing drainage and risking pneumothorax or tension pneumothorax, requiring immediate repositioning. Continuous bubbling in the water seal is expected initially, and the other findings are appropriate.
The nurse enters the playroom and finds an 8-year-old child having a grand mal seizure. Which one of the following actions should the nurse take?
- A. Place a tongue blade in the child's mouth.
- B. Restrain the child so he will not injure himself.
- C. Go to the nurses station and call the physician.
- D. Move furniture out of the way and place a blanket under his head.
Correct Answer: D
Rationale: The nurse should not put anything in the child's mouth during a seizure; this action could obstruct the airway. Restraining the child's movements could cause constrictive injury. Staying with the child during a seizure provides protection and allows the nurse to observe the seizure activity. The nurse should provide safety for the child by moving objects and protecting the head.
Which of the following procedures is necessary to establish a definitive diagnosis of breast cancer?
- A. Diaphanography
- B. Mammography
- C. Thermography
- D. Breast tissue biopsy
Correct Answer: D
Rationale: Diaphanography, also known as transillumination, is a painless, noninvasive imaging technique that involves shining a light source through the breast tissue to visualize the interior. It must be used in conjunction with a mammogram and physical examination. Mammography is a useful tool for screening but is not considered a means of diagnosing breast cancers. Thermography is a pictorial representation of heat patterns on the surface of the breast. Breast cancers appear as a 'hot spot' owing to their higher metabolic rate. Biopsy either by needle aspiration or by surgical incision is the primary diagnostic technique for confirming the presence of cancer cells.