Nokea
The nurse is caring for a client with bacterial meningitis who has been placed on droplet precautions. Which personal protection is mandatory for the nurse when administering medications?
- A. Face shield
- B. Gown
- C. N95 respirator
- D. Surgical mask
Correct Answer: D
Rationale: Droplet precautions for bacterial meningitis require a surgical mask to prevent transmission via respiratory droplets. A face shield, gown, or N95 respirator is not mandatory unless additional precautions are indicated.
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A young couple asks the nurse what method of contraception they should use. What information is most important for the nurse to have before giving an answer?
- A. The exact age of the couple
- B. The sexual history of both partners
- C. The method they find most acceptable
- D. How soon they want to start a family
Correct Answer: C
Rationale: The couple's preferred contraceptive method ensures adherence and satisfaction, guiding the nurse's recommendations. Age, sexual history, or family planning timeline are secondary.
In an obstetrical emergency, which of the following actions should the nurse perform first after the baby delivers?
- A. Place extra padding under the mother to absorb blood from the delivery.
- B. Cut the umbilical cord using sterile scissors.
- C. Suction the baby's mouth and nose.
- D. Wrap the baby in a clean blanket to preserve warmth.
Correct Answer: C
Rationale: Suctioning the baby's mouth and nose first ensures a clear airway, critical for newborn respiration. Other actions follow based on the situation. Safety and Infection Control
All of the following are common reasons that nurses are reluctant to delegate except:
- A. lack of self-confidence.
- B. desire to maintain authority.
- C. confidence in subordinates.
- D. getting trapped in the 'I can do it better myself' mindset.
Correct Answer: C
Rationale: Confidence in subordinates encourages delegation, while lack of confidence, desire for control, or perfectionism are common barriers to delegating tasks. Coordinated Care
Client self-determination is the primary focus of:
- A. malpractice insurance.
- B. nursing's advocacy for clients.
- C. confidentiality.
- D. health care.
Correct Answer: B
Rationale: Nursing advocacy prioritizes client self-determination, supporting autonomy in healthcare decisions. The other options address different aspects of care or legal protection. Coordinated Care
The nurse is talking with a client with obsessive-compulsive disorder. When the client performs ritualistic behaviors, the nurse should recognize that the client
- A. is hearing voices
- B. is trying to control feelings of anger
- C. has an intense desire to control the environment
Correct Answer: C
Rationale: Ritualistic behaviors in OCD are driven by an intense need to control the environment or reduce anxiety through repetitive actions. They are not related to hearing voices or controlling anger, which are more associated with other disorders.