Nokea
The nurse is admitting a 3-year-old child who is thought to have meningococcal meningitis. What type of room assignment is most appropriate?
- A. Private room
- B. Semi-private room with a child of the same age
- C. Isolation room
- D. A room close to the nurse's station
Correct Answer: C
Rationale: Meningococcal meningitis is highly contagious, requiring droplet isolation in an isolation room to prevent spread, unlike private or semi-private rooms.
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A patient is admitted to the surgical unit with a diagnosis of rule out intestinal obstruction. The nurse is preparing to insert a Salem sump NG tube as ordered. In which of the following positions would it be BEST for the nurse to place this patient during the procedure?
- A. Head of bed elevated 30°-45°.
- B. Head of bed elevated 60°-90°.
- C. Side-lying with head elevated 15°.
- D. Lying flat with head turned to the left side.
Correct Answer: B
Rationale: Positioning the patient with the head of the bed elevated 60°-90° (high Fowler’s position) facilitates swallowing and allows gravity to aid the passage of the nasogastric (NG) tube through the esophagus into the stomach. This position reduces the risk of aspiration and eases tube insertion. Lower elevations (30°-45°), side-lying, or flat positions do not optimize swallowing or tube advancement as effectively.
A client with a history of Addison's disease and flulike symptoms accompanied by nausea and vomiting over the past week is brought to the facility. The client's wife reports that she noticed that he acted confused and was extremely weak when he woke up in the morning. The client's blood pressure is 90/58 mm Hg, his pulse is 116 beats/minute, and his temperature is 101°F (38.3°C). A diagnosis of acute adrenal insufficiency is made. Which of the following would the nurse expect to administer by I.V. infusion?
- A. Insulin
- B. Hydrocortisone
- C. Potassium
- D. Hypotonic saline
Correct Answer: B
Rationale: Emergency treatment for acute adrenal insufficiency (addisonian crisis) is I.V. infusion of hydrocortisone and saline solution. The client is usually given 100 mg of hydrocortisone in normal saline every 6 hours until his blood pressure returns to normal. Insulin isn't indicated in this situation because adrenal insufficiency is usually associated with hypoglycemia. Potassium isn't indicated because these clients are usually hyperkalemic. The client needs normal - not hypotonic - saline solution.
The nurse is caring for a client receiving total parenteral nutrition (TPN). Which of the following findings would indicate a complication of TPN therapy?
- A. Weight gain of 0.5 kg in 24 hours.
- B. Blood glucose level of 200 mg/dL.
- C. Temperature of 99°F (37.2°C).
- D. Urine output of 50 mL/hour.
Correct Answer: B
Rationale: A blood glucose level of 200 mg/dL indicates hyperglycemia, a common TPN complication due to high dextrose content, requiring insulin adjustment or rate change. Weight gain (A) is expected, low-grade fever (C) is nonspecific, and normal urine output (D) is unremarkable.
A client has been on antibiotics for 72 hours for cystitis. Which report from the client requires priority attention by the nurse?
- A. foul smelling urine
- B. burning on urination
- C. elevated temperature
- D. nausea and anorexia
Correct Answer: C
Rationale: Elevated temperature after 72 hours on an antibiotic indicates the antibiotic has not been effective in eradicating the offending organism. The provider should be informed immediately so that an appropriate medication can be prescribed, and complications such as pyelonephritis are prevented.
What is the appropriate ratio of cardiac compressions to ventilations in an adult client for one-person CPR?
- A. 5:01
- B. 1:05
- C. 15:02
- D. 2:15
Correct Answer: C
Rationale: The appropriate ratio for adult CPR is 15 compressions to 2 ventilations.