Nokea
The nurse is caring for a 4-year-old client with cystic fibrosis who uses a high-frequency chest wall oscillation (HFCWO) vest for chest physiotherapy. After reinforcing education with the client's parents, which statement by a parent requires further teaching?
- A. I will allow my child to have a snack while using the HFCWO vest to encourage cooperation.
- B. I will give my child the nebulized bronchodilator treatment during therapy with the HFCWO vest.
- C. I will perform manual chest percussion on my child if the HFCWO vest is broken or unavailable.
- D. My child will use the HFCWO vest once in the morning, once in the evening, and as needed.
Correct Answer: A
Rationale: Eating during HFCWO vest use can increase the risk of aspiration or reduce therapy effectiveness, indicating a need for further teaching. Bronchodilators during therapy, manual percussion as a backup, and the described frequency are appropriate.
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The mother of a burned child asks the nurse to clarify what is meant by a third degree burn. The best response by the nurse is
- A. The top layer of the skin is destroyed.'
- B. The skin layers are swollen and reddened.'
- C. All layers of the skin were destroyed in the burn.'
- D. Muscle, tissue and bone have been injured.'
Correct Answer: C
Rationale: All layers of the skin were destroyed in the burn.' A third degree burn is a full thickness injury to dermis, epidermis and subcutaneous tissue.
The nurse provides an in-service for hospital staff on how to prevent pressure injuries in clients with limited mobility. Which instructions are appropriate for the nurse to include? Select all that apply.
- A. Apply moisture barrier cream to dry skin
- B. Clean perineal area after incontinent episodes
- C. Massage bony prominences frequently
- D. Place foam-padded seat cushions on chairs
- E. Reposition clients in bed every 6 hours
Correct Answer: A,B,D
Rationale: Moisture barrier cream protects skin, cleaning after incontinence prevents irritation, and foam cushions reduce pressure. Massaging bony prominences can cause tissue damage, and repositioning every 6 hours is too infrequent; every 2 hours is standard.
The nurse is preparing to administer 40 mg of oral furosemide. Prior to administering the medication, the nurse should evaluate which parameters? Select all that apply.
- A. Blood pressure
- B. Blood urea nitrogen
- C. Liver enzymes
- D. Potassium
- E. White blood cell count
Correct Answer: A,D
Rationale: Furosemide can cause hypotension and hypokalemia, so blood pressure and potassium levels must be evaluated. Blood urea nitrogen reflects kidney function but is not critical before administration, and liver enzymes and white blood cell count are unrelated.
When counseling parents of a child who has recently been diagnosed with hemophilia, what must the nurse know about the offspring of a normal father and a carrier mother?
- A. It is likely that all sons are affected
- B. There is a 50% probability that sons will have the disease
- C. Every daughter is likely to be a carrier
- D. There is a 25% chance a daughter will be a carrier
Correct Answer: D
Rationale: There is a 25% chance a daughter will be a carrier. Hemophilia A is sex-linked recessive, with a 25% chance of a carrier female per pregnancy.
The nurse is caring for a client who has oral candidiasis. The nurse should expect that the client will be prescribed
- A. nystatin
- B. acyclovir
- C. mupirocin
- D. griseofulvin
Correct Answer: A
Rationale: Nystatin is an antifungal medication specifically used to treat oral candidiasis (thrush). Acyclovir treats viral infections, mupirocin is for bacterial skin infections, and griseofulvin treats fungal skin infections, not oral candidiasis.