Nokea
The mother of a six-year-old with autistic disorder tells the nurse that her son has been much more difficult to care for since the birth of his sister. The best explanation for changes in the child's behavior is:
- A. The child did not want a sibling.
- B. The child was not adequately prepared for the baby's arrival.
- C. The child's daily routine has been upset by the birth of his sister.
- D. The child is just trying to get the parent's attention.
Correct Answer: C
Rationale: Children with autism often rely on structured routines, and disruptions, such as a new sibling, can lead to behavioral changes due to difficulty adapting to change.
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Which finding is considered a risk factor in the development of leukemia?
- A. The client is an avid stamp collector.
- B. The client works as a computer programmer.
- C. The client had radiation for Hodgkin's lymphoma.
- D. The client's grandmother had stomach cancer.
Correct Answer: C
Rationale: Radiation exposure such as from treatment for Hodgkin’s lymphoma is a known risk factor for leukemia. Stamp collecting computer programming and a family history of stomach cancer are not established risk factors.
A client who had major abdominal surgery is having delayed healing of the wound. Which laboratory test result would most closely correlate with this problem?
- A. Decreased albumin
- B. Decreased creatinine
- C. Increased calcium
- D. Increased sodium
Correct Answer: A
Rationale: Decreased albumin indicates protein deficiency, impairing tissue repair and delaying wound healing. Decreased creatinine (B) reflects renal function, increased calcium (C) affects bones, and increased sodium (D) affects fluid balance, not healing directly.
The nurse is teaching a client with a history of migraines about trigger avoidance. The nurse should tell the client to avoid:
- A. Chocolate
- B. Fresh vegetables
- C. Lean meats
- D. Whole grains
Correct Answer: A
Rationale: Chocolate is a common migraine trigger, potentially causing vasoconstriction or neurotransmitter changes, so it should be avoided.
The nurse is teaching a mother care of her child's spica cast. The mother states that he complains of itching under the edge of the cast. One nonpharmacological technique the nurse might suggest would be:
- A. Blowing air under the cast using a hair dryer on cool setting often relieves itching.
- B. Slide a ruler under the cast and scratch the area.
- C. Guide a towel under and through the cast and move it back and forth to relieve the itch.
- D. Gently thump on cast to dislodge dried skin that causes the itching.
Correct Answer: A
Rationale: Cool air will often relieve pruritus without damaging the cast or irritating the skin. The nurse should never force anything under the cast, because the cast may become damaged and skin breakdown may occur. Forcing an object under the cast could lead to cast damage and skin breakdown. The object may become lodged under the cast necessitating cast removal. This technique does not dislodge skin cells. It could damage the cast and cause skin breakdown.
The nurse is teaching a client with a history of atrial fibrillation about medication adherence. The nurse should tell the client to:
- A. Take anticoagulants as prescribed
- B. Skip doses if feeling better
- C. Increase caffeine intake
- D. Avoid hydration
Correct Answer: A
Rationale: Anticoagulants reduce stroke risk in atrial fibrillation, so adherence is critical.