The nurse is obligated to make a report for which situations...

The nurse is obligated to make a report for which situations? Select all that apply.

A. Report to a client's employer that the client had a car crash while intoxicated
B. Report to the authorities of a death by suicide on the unit
C. Report to the client's spouse that the client has a reportable sexually transmitted disease
D. Report to the hotline that an elderly client has suspicious bruising but denies caregiver abuse
E. Report to the supervisor that a health care provider has the smell of alcohol on the breath

Correct Answer: B,D,E

Rationale: Reporting is mandatory for suicides, suspected elder abuse, and impaired providers. Reporting to employers or spouses violates confidentiality.

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A client 4 days post colostomy is preparing to be discharged home. Which findings are concerning and should be further investigated? Select all that apply.

A. Client states, 'I will need home health to empty the pouch.'
B. Client states, 'There is a little gas in the colostomy bag.'
C. No bowel sounds are present and the client reports nausea
D. Skin surrounding the stoma is red and excoriated
E. Stoma is red, edematous, and smaller than the previous day

Correct Answer: C,D,E

Rationale: Absent bowel sounds with nausea suggest obstruction, red/excoriated skin indicates irritation, and a shrinking stoma may signal complications. Gas is normal, and needing home health is not inherently concerning.

A woman in labor calls the nurse to assist her in the bathroom. The nurse notices a large amount of clear fluid on the bed linens. The nurse knows that fetal monitoring must now assess for what complication?

A. Early decelerations
B. Late accelerations
C. Variable decelerations
D. Periodic accelerations

Correct Answer: C

Rationale: When the membranes rupture, there is increased risk initially of cord prolapse. Fetal heart rate patterns may show variable decelerations, which require immediate nursing action to promote gas exchange.

The nurse is preparing the room of a client returning from a subtotal thyroidectomy. Which item should be placed at the bedside of a client with a subtotal thyroidectomy?

A. An ambu bag
B. A tracheostomy set
C. An endotracheal tube
D. A ventilator

Correct Answer: B

Rationale: A tracheostomy set is essential post-thyroidectomy due to the risk of airway obstruction from swelling or hematoma. Other equipment is less immediately relevant.

A client with throat cancer receives radiation therapy to the head and neck. Which of the following strategies are appropriate to decrease the adverse effects associated with radiation therapy? Select all that apply.

A. Avoid irritants such as acidic, spicy foods
B. Discourage the use of topical analgesics
C. Encourage liquid nutritional supplements
D. Perform oral hygiene once per day
E. Use artificial saliva to control dryness

Correct Answer: A,C,E

Rationale: Avoiding irritants reduces mucosal irritation. Liquid supplements ensure adequate nutrition when swallowing is difficult. E: Artificial saliva alleviates xerostomia, a common side effect. B is incorrect as topical analgesics may be beneficial for pain relief. D is incorrect as frequent oral hygiene is needed to prevent infections and maintain oral health.

A 19-year-old primigravida is admitted for observation due to a sudden increase in blood pressure. The doctor suspects a diagnosis of pregnancy-induced hypertension. Which of the following is considered a significant factor in the development of pregnancy-induced hypertension?

A. Maternal age
B. Nutritional status of mother
C. Pre-pregnant weight
D. History of hypertension

Correct Answer: D

Rationale: A history of hypertension is a significant risk factor for developing pregnancy-induced hypertension (preeclampsia), as it indicates a predisposition to vascular issues.