Nokea
The nurse is preparing to instill dialysate for a client who is receiving peritoneal dialysis. It would be a priority for the nurse to
- A. place the client in the semi-Fowler position
- B. record the characteristics of the dialysate output
- C. use sterile technique when spiking and attaching the bag of dialysate
- D. ensure that the drainage collection bag is below the level of the abdomen
Correct Answer: C
Rationale: Sterile technique when spiking and attaching the dialysate bag prevents peritonitis, a life-threatening complication. Semi-Fowler positioning, recording output, and bag placement are important but secondary to infection prevention.
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The health care provider prescribes a multivitamin regimen that includes thiamine for a client with a history of chronic alcohol abuse. The nurse is aware that thiamine is given to this client population for which purpose?
- A. To lower the blood alcohol level
- B. To prevent gross tremors
- C. To prevent Wernicke encephalopathy
- D. To treat seizures related to acute alcohol withdrawal
Correct Answer: C
Rationale: Thiamine prevents Wernicke encephalopathy, a neurological disorder from thiamine deficiency common in chronic alcoholism. It does not lower alcohol levels, prevent tremors, or treat seizures directly.
Which are appropriate examples of cost-effective care? Select all that apply.
- A. Considering the inside of the sterile glove wrapper as a small sterile field
- B. Donning clean, rather than sterile, gloves to remove a client’s dressing
- C. Returning opened, unused supplies from a client’s room to the central supply room
- D. Reusing a tourniquet for multiple clients unless it is visibly soiled
- E. Using remaining sterile saline in a bottle opened 48 hours ago before discarding
Correct Answer: A,B
Rationale: Using the glove wrapper as a sterile field and clean gloves for dressing removal reduce waste without compromising safety. Returning supplies, reusing tourniquets, and using old saline risk contamination or infection.
The summer camp nurse and parent of a 9-year-old with juvenile idiopathic arthritis (JIA) are discussing appropriate physical activities for the child. Which of the following activities should be included? Select all that apply.
- A. Dodgeball
- B. Reading a book
- C. Stationary bicycling
- D. Swimming
- E. Yoga
Correct Answer: C,D,E
Rationale: Stationary bicycling, swimming, and yoga are low-impact, joint-friendly activities for JIA. Dodgeball risks joint stress, and reading, while safe, is not a physical activity.
What nursing action is essential when oxygen is ordered for a client who is living at home?
- A. Assist the client and family in checking all electrical appliances in the vicinity for frayed cords.
- B. Encourage the client and family to purchase fire extinguishers.
- C. Remove electrical devices from the room where oxygen is in use.
- D. Encourage the client and family to carpet the client's room.
Correct Answer: A
Rationale: Checking for frayed cords reduces fire risk, as oxygen supports combustion. Extinguishers are secondary, removing devices is impractical, and carpeting increases static sparks.
A laboring woman prefers to lie in the supine position during labor. The nurse teaches her that this is not a good position for which reason?
- A. It will cause more back pressure.
- B. Her baby will not come down well into the pelvis.
- C. Her blood pressure may drop and cause the baby's heart rate to drop.
- D. Contractions will be too close together, not giving her a rest.
Correct Answer: C
Rationale: Supine position can compress the vena cava, causing maternal hypotension and reduced fetal perfusion, leading to fetal heart rate drops.