Nokea
The nurse is completing admission on a client with possible esophageal cancer. Which finding would not be common for this diagnosis?
- A. Foul breath
- B. Dysphagia
- C. Diarrhea
- D. Chronic hiccups
Correct Answer: C
Rationale: Esophageal cancer commonly presents with dysphagia, foul breath (due to tumor necrosis), and chronic hiccups (from diaphragmatic irritation). Diarrhea is not typically associated with esophageal cancer.
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A 3-year-old child had a PPD skin test 2 days ago. When the mother brings the child back to the clinic to have the nurse check the results, the nurse notes a 10 mm area of induration. This is considered
- A. an inconclusive skin test.
- B. a positive skin test.
- C. a negative skin test.
- D. too early to determine the results.
Correct Answer: B
Rationale: A 10 mm induration 48-72 hours post-PPD is positive in children, indicating TB exposure, especially in high-risk groups.
The physician has ordered that a 132-pound client with increased intracranial pressure receive 0.5 g of mannitol per kg in an IV solution. How many grams should be in the total mannitol dose? Record your answer using a whole number.
Correct Answer: 30
Rationale: Weight = 132 lb/ 2.2 = 60 kg. Dose = 0.5 g/kg X 60 kg = 30 g.
A client is admitted to the surgical unit following a transurethral prostatectomy (TURP). The nurse administers a B&O suppository to help prevent bladder spasms. The nurse would observe the client for:
- A. Insomnia and hyperactivity
- B. Physiological dependence on the drug
- C. Nausea and vomiting
- D. Diarrhea and abdominal cramping
Correct Answer: C
Rationale: Belladonna and opium (B&O) suppositories can cause nausea and vomiting as side effects. These are more immediate concerns than dependence or the other symptoms.
A child was exposed to the hepatitis A virus, became ill, and made a full recovery 2 years ago. The child is now immune to the hepatitis A virus and will likely be protected for the rest of her life. This type of immunity is referred to as
- A. active artificial immunity.
- B. naturally acquired active immunity.
- C. artificially acquired passive immunity.
- D. naturally acquired passive immunity.
Correct Answer: B
Rationale: Recovery from hepatitis A infection confers lifelong immunity via naturally acquired active immunity, as the body produces its own antibodies.
The nurse is serving on the performance improvement committee, which has agreed to some changes in procedures on the basis of evidence-based research. If the committee wants to convince staff members to comply with the changes, which of the following actions should the committee carry out first?
- A. Identify and gain support of key staff.
- B. Explain the consequences of failure to comply.
- C. Determine a reward system for compliance.
- D. Clearly outline expectations in written format.
Correct Answer: A
Rationale: Gaining key staff support (A) builds buy-in and facilitates change adoption. Consequences (B), rewards (C), or written expectations (D) follow.