Nokea
The nurse, assisting in applying a cast to a client with a broken arm, knows that the
- A. Cast material should be dipped several times into the warm water
- B. Cast should be covered until it dries
- C. Wet cast should be handled with the palms of hands
- D. Casted extremity should be placed on a cloth-covered surface
Correct Answer: C
Rationale: Wet cast should be handled with the palms of hands. This prevents damage to the cast and ensures proper setting.
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A 6-month-old infant is being seen in the doctor's office. Which observation by the nurse should be brought to the physician's attention?
- A. The baby sits up but needs slight support.
- B. The baby was 7 lb at birth and now weighs 10 lb.
- C. The baby frequently drops objects and looks for them.
- D. The baby smacks her lips and drools.
Correct Answer: B
Rationale: A 6-month-old should double birth weight (14 lb expected for 7 lb); 10 lb suggests poor growth, requiring evaluation. Other findings are developmentally normal.
A nurse receives report on a group of clients. Which client should the nurse assess first?
- A. A preschool-age child with a harsh cough, expiratory wheezes, and mild intercostal retractions
- B. A toddler playing with small toys who appears in distress, has circumoral cyanosis, and cannot speak
- C. A toddler with a barking cough, infrequent inspiratory stridor, and oxygen saturation of 94% on room air
- D. An infant with an axillary temperature of 100.1 F (37.8 C) who is tugging at the left ear
Correct Answer: B
Rationale: The toddler with circumoral cyanosis, distress, and inability to speak suggests a potential airway obstruction, a life-threatening emergency requiring immediate assessment. Other clients show less acute symptoms.
Which of these findings indicate that a pump set to deliver a basal rate of 10 ml per hour plus PRN morphine drip for breakthrough pain is not working?
- A. The client complains of discomfort at the IV insertion site
- B. The client states 'I just can't get relief from my pain'
- C. The level of the drug is 100 ml at 8 AM and is 80 ml at noon
- D. The infusion is running at a rate higher than expected
Correct Answer: C
Rationale: The minimal dose is 10 ml per hour, which would mean 40 mls are given in a 4 hour period. Only 60 mls should be left at noon. The pump is not functioning when more than expected medicine is left in the container.
The nurse is caring for a man who had a transsphenoidal hypophysectomy earlier today. He says he has to spit a lot. What nursing action is essential?
- A. Ask him to blow his nose.
- B. Do a glucose test on his mouth secretions.
- C. Have him rinse his mouth with water.
- D. Ask him if he needs an antiemetic.
Correct Answer: B
Rationale: Excessive spitting may indicate cerebrospinal fluid (CSF) leak, which contains glucose; testing secretions confirms this serious complication.
The practical nurse is assisting the registered nurse in creating a care plan for a client who is intubated, on mechanical ventilation, and receiving continuous enteral tube feedings via a small-bore nasogastric tube. Which interventions should be included to prevent aspiration in this client? Select all that apply.
- A. Check gastric residual every 12 hours
- B. Keep head of the bed at ≥30 degrees
- C. Maintain endotracheal cuff pressure
- D. Monitor for abdominal distension every 4 hours
- E. Use caution when administering sedatives
Correct Answer: B,C,D,E
Rationale: Elevating the head of the bed (≥30 degrees) reduces reflux, proper cuff pressure seals the airway, monitoring distension detects feed intolerance, and cautious sedation prevents respiratory depression. Residual checks every 4-6 hours are standard, not 12.