Nokea
The nurse is assisting in the attempt to control bleeding from an artery. What personal protection equipment should be worn?
- A. Gloves only
- B. Gown, gloves, mask, and goggles
- C. Mask and gown
- D. None because time should not be wasted
Correct Answer: B
Rationale: Gown, gloves, mask, and goggles protect against blood splatter during arterial bleeding control, adhering to standard precautions.
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The nurse has just received the shift report. Which one of the following clients should be seen first?
- A. A 14-year-old one day post-appendectomy with a WBC of 6500
- B. A 5-year-old three days post-fracture of the right tibia with a temperature of 101° Fahrenheit
- C. An 11-month-old admitted during the previous shift with dehydration and a hematocrit of 40
- D. An 8-week-old admitted four hours earlier with sub-sternal retractions and an oxygen saturation of 90%
Correct Answer: D
Rationale: Answer D is correct. There is nothing in answer A that indicates the client is unstable. Answer B is a good choice, but the client three days post-fracture may have a slight temperature, so he should be seen second. Answer C is also a good choice, but if the infant with dehydration is stable, the 8-week-old with respiratory distress (sub-sternal retractions and low oxygen saturation) is the most critical and should be seen first.
The nurse would expect the cystic fibrosis client to receive supplemental pancreatic enzymes along with a diet
- A. High in carbohydrates and proteins
- B. Low in carbohydrates and proteins
- C. High in carbohydrates, low in proteins
- D. Low in carbohydrates, high in proteins
Correct Answer: A
Rationale: High in carbohydrates and proteins. This diet supports energy needs and compensates for malabsorption in cystic fibrosis.
The nurse is caring for a client who had surgery yesterday. When administering omeprazole, the client asks 'What is that for? I don't take it at home.' Which reply by the nurse is most appropriate?
- A. Omeprazole helps prevent nausea by making your stomach empty faster.'
- B. Omeprazole helps prevent you from developing an ulcer due to the stress of surgery.'
- C. Omeprazole protects you from getting an infection while on antibiotics.'
- D. This medication will treat your gastroesophageal reflux disease (GERD).'
Correct Answer: B
Rationale: Omeprazole is a proton pump inhibitor used postoperatively to prevent stress ulcers due to surgical stress. It does not affect gastric emptying , prevent infections , or assume GERD without a diagnosis.
The practical nurse is assisting the registered nurse in creating a teaching plan for the parents of a child diagnosed with pediculosis capitis. Which instructions should be included in the teaching plan? Select all that apply.
- A. It is not necessary to treat other children in the household
- B. Soak the child's comb and hair accessories in boiling water for 10 minutes
- C. The family pet will need treatment with a pediculicide
- D. Use a nit comb daily for 2 weeks after pediculicide treatment
- E. Vacuum the furniture, carpets, and mattresses every few days
Correct Answer: B,D,E
Rationale: For pediculosis capitis (head lice), soaking combs in boiling water , using a nit comb daily , and vacuuming furniture prevent reinfestation. Other children should be checked and treated if infested (A is incorrect), and pets do not require treatment as lice are human-specific.
The nurse is caring for a client who has a prescription for clarithromycin 7.5 mg/kg/day PO in 2 divided doses. The client weighs 78 lb. How many mL should the nurse administer for each dose? Record your answer using 1 decimal place.
Correct Answer: 7.5 mL/dose
Rationale: Client weight: 78 lb ÷ 2.2 = 35.45 kg. Dose: 7.5 mg/kg/day × 35.45 kg = 265.875 mg/day ÷ 2 doses = 132.9375 mg/dose. Clarithromycin is typically 250 mg/5 mL. Thus, 132.9375 mg × (5 mL/250 mg) = 2.65875 mL ≈ 2.7 mL/dose.