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The nurse is assessing a neonate at 5 minutes after birth. The nurse records the Apgar score based on the findings in the chart A. The nurse compares these findings to the Apgar score obtained at birth, as determined by the findings in the chart B. What should the nurse do next?
- A. Notify the neonatologist on call.
- B. Continue to assess the neonate.
- C. Apply an oxygen mask.
- D. Rub the neonate’s extremities.
Correct Answer: B
Rationale: The neonate’s Apgar score has been improving since birth. (The birth score is 6; the current score is 9.) The nurse should continue to assess the neonate. There is no indication that oxygen is
needed since the color is improving, and stimulating the baby is not necessary as the he is now fl exing his extremities.
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A client with a diagnosis of Parkinson's disease is prescribed pramipexole (Mirapex). The nurse should monitor the client for which of the following side effects?
- A. Hypertension.
- B. Drowsiness.
- C. Weight gain.
- D. Hyperglycemia.
Correct Answer: B
Rationale: Pramipexole, a dopamine agonist, commonly causes drowsiness, which the nurse should monitor in Parkinson's clients.
A couple has completed testing and is a candidate for in vitro fertilization. The nurse is reviewing the procedure with them and realizes that further instruction is needed when the woman states:
- A. One of the greatest risks is multiple pregnancies.'
- B. I will need to redefine how I view my job if I do become pregnant.'
- C. The fertilization procedure can be done anytime during my cycle.'
- D. We can use our own eggs and sperm or someone else's.'
Correct Answer: C
Rationale: IVF requires precise timing with the menstrual cycle, so the statement about performing it anytime indicates a need for further instruction.
A client was treated for a streptococcal throat infection 2 weeks ago. The client now has been diagnosed with acute poststreptococcal glomerulonephritis. The client asks the nurse how he could have prevented this condition. What should the nurse tell the client?
- A. See your physician for an early diagnosis and treatment of a sore throat.'
- B. As long as you do not have a fever, it is sufficient to gargle daily with an antibacterial mouthwash.'
- C. You may continue to utilize the previously prescribed antibiotics until they are gone.'
- D. Unscented bar soap may be used in showers.'
Correct Answer: A
Rationale: Early diagnosis and treatment of streptococcal infections prevent complications like glomerulonephritis. Mouthwash, leftover antibiotics, or soap use are not preventive measures.
A child is brought to the emergency department after being bitten on the arm by a neighborhood dog. Which is the priority question for the nurse to ask the parent of the child?
- A. How old is the dog?
- B. Does the dog have a history of biting?
- C. Are the child's immunizations up-to-date?
- D. Did the dog have all of its recommended shots?
Correct Answer: C
Rationale: When a bite occurs, the injury site of the bite should be cleansed carefully and the child should be given tetanus prophylaxis if immunizations are not up-to-date. The remaining options identify information that may have to be obtained, but are not the priority questions. Additionally the mother may not have the answers to these questions.
The nurse is caring for a client with a history of Crohn's disease who is prescribed mesalamine (Asacol). The nurse should instruct the client to report which of the following side effects immediately?
- A. Mild diarrhea.
- B. Abdominal pain.
- C. Fever.
- D. Headache.
Correct Answer: C
Rationale: Fever may indicate an exacerbation of Crohn's disease or a side effect of mesalamine, requiring immediate reporting.