Nokea
The nurse believes a coworker is diverting narcotics. The nurse approaches the nurse manager to report the suspicions. Which of the following statements by the nurse is BEST?
- A. After my coworker has been on duty, the patients often need repeated doses of pain medication. I have seen her/him sleeping on duty three times.
- B. I saw my coworker downtown after work. S/he was acting really strange, like s/he didn't even recognize me.
- C. I think my coworker is stealing narcotics because s/he is always acting euphoric and seems high.
- D. I am sure my coworker is hanging around with drug dealers, and I think I saw tracks on her/his arms.
Correct Answer: A
Rationale: Objective observations, such as increased patient pain medication needs and sleeping on duty, provide verifiable evidence for investigation. Options B, C, and D are subjective or speculative, reducing their credibility.
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The nurse is assigned to work with the parents of a retarded child.
- A. What should the nurse include in the care plan for the parents of a retarded child?
- B. Interpret the grieving process for the parents.
- C. Discuss the reality of institutional placement.
- D. Assist the parents in making decisions and long-term plans for the child.
- E. Perform a family assessment to assist in the planning of intervention.
Correct Answer: D
Rationale: A family assessment is essential to understand the parents’ grieving, coping, and support needs, guiding tailored interventions. Interpreting grief, discussing placement, or assisting with plans are premature without first assessing the family’s situation.
An obstetrical client elects to have epidural anesthesia with Marcaine. After the epidural anesthesia is given, the nurse should monitor the client for signs of:
- A. Seizure activity
- B. Respiratory depression
- C. Postural hypotension
- D. Hematuria
Correct Answer: C
Rationale: Marcaine (bupivacaine) can cause vasodilation, leading to postural hypotension. Seizures, respiratory depression, and hematuria are less common.
The LPN/LVN is to perform a sterile procedure. Which action will maintain a sterile field?
- A. Keeping the sterile field within the line of vision
- B. Opening sterile packages with sterile gloves
- C. Talking to others over the sterile field
- D. Handing the physician medicine over the sterile field
Correct Answer: A
Rationale: Keeping the sterile field in view ensures no contamination occurs, maintaining sterility during the procedure.
The nurse is caring for a person who has a nasogastric tube attached to drainage. Which complaint by the client needs to be reported to the charge nurse?
- A. Dry mouth
- B. Weak muscles
- C. Sore throat
- D. Irritated nose
Correct Answer: C
Rationale: A sore throat may indicate nasogastric tube complications like erosion or infection, requiring evaluation. Dry mouth, weakness, or nasal irritation are expected.
The nurse is discussing negativity with the parents of a 30 month-old child. How should the nurse tell the parents to best respond to this behavior?
- A. Reprimand the child and give a 15 minute 'time out'
- B. Maintain a permissive attitude for this behavior
- C. Use patience and a sense of humor to deal with this behavior
- D. Assert authority over the child through limit setting
Correct Answer: C
Rationale: Use patience and a sense of humor to deal with this behavior. This approach supports the toddler’s developing autonomy.