The most appropriate toys to give to a 5-month-old infant are:
- A. Plastic toy cars.
- B. Wooden puzzles.
- C. Stuffed animals.
- D. Soft, washable toys.
Correct Answer: D
Rationale: Soft, washable toys are safe and appropriate for a 5-month-old, who explores through touch and mouthing. Toy cars and puzzles are choking hazards, and stuffed animals may pose hygiene risks.
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The nurse caring for a client immediately following transurethral resection of the prostate (TURP) notices that the client has suddenly become confused and disoriented. The nurse determines that this may be a result of which potential complication of this surgical procedure?
- A. Hyponatremia
- B. Hypernatremia
- C. Hypochloremia
- D. Hyperchloremia
Correct Answer: A
Rationale: The client who suddenly becomes disoriented and confused after TURP could be experiencing early signs of hyponatremia. This may occur because the flushing solution used during the operative procedure is hypotonic. If enough solution is absorbed through the prostate veins during surgery, the client experiences increased circulating volume and dilutional hyponatremia. The nurse needs to report these symptoms. The conditions noted in the other options are not complications of the procedure.
What is the expected date of delivery for your pregnant client when her last menstrual period was on 10/20/2016?
- A. 7/7/2017
- B. 8/7/2017
- C. 6/7/2017
- D. 8/1/2017
Correct Answer: A
Rationale: Using Naegele's rule, add 1 year and 7 days to the first day of the last menstrual period (10/20/2016), then subtract 3 months: 10/20/2016 + 1 year = 10/20/2017, + 7 days = 10/27/2017, - 3 months = 7/27/2017. Adjusting for a standard 40-week gestation, the expected delivery date is approximately 7/7/2017.
A client with a history of heart failure is prescribed metoprolol (Lopressor). The nurse should monitor the client for which of the following side effects?
- A. Hypertension.
- B. Bradycardia.
- C. Hyperglycemia.
- D. Weight loss.
Correct Answer: B
Rationale: Metoprolol, a beta-blocker, can cause bradycardia, requiring close monitoring of heart rate.
The best way to objectively evaluate the effectiveness of an individual staff member's time management skills in a longitudinal manner is to:
- A. Observe the staff member during an entire shift of duty to determine whether or not the nurse has accurately and appropriately established priorities.
- B. Observe the staff member during an entire shift of duty to determine whether or not the nurse has accurately and appropriately completed priority tasks.
- C. Ask the staff member how they feel like they have been able to employ their time management skills for the last six months.
- D. Collect outcome data over time and then aggregate and analyze this data to determine whether or not the staff member has completed reasonable assignments in the allotted time before the end of their shift of duty.
Correct Answer: D
Rationale: To objectively evaluate time management skills over time, collecting, aggregating, and analyzing outcome data provides a longitudinal perspective on whether the staff member consistently completes assignments within the allotted time. This method is more objective than single-shift observations (A, B) or self-reports .
The nurse instructs the client in mixing and administering regular and NPH insulin. Which of the following statements indicates that the client needs additional instruction?
- A. I draw up the regular insulin first
- B. I shake the bottle of NPH insulin before drawing it up
- C. I store the insulin in a cool place
- D. I insert the needle at a 90-degree angle
Correct Answer: B
Rationale: Shaking NPH insulin can damage it; it should be gently rolled. Drawing up regular insulin first, cool storage, and a 90-degree injection angle are correct practices.
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