Nokea
The nurse is reinforcing teaching to the caregiver of a child diagnosed with ringworm on the abdomen. Which statement by the caregiver indicates a need for further teaching?
- A. Handwashing is very important as ringworm can be spread among humans and pets.
- B. I must apply antifungal cream to all affected areas to eradicate ringworm from the body.
- C. My child has been infected by a worm and must be treated to rid it from the body.
- D. My child may be uncomfortable due to itching, but this is not a dangerous condition.
Correct Answer: C
Rationale: Ringworm is a fungal infection, not a parasitic worm (C), indicating a misunderstanding requiring further teaching. Handwashing (A), antifungal cream (B), and recognizing itching as non-dangerous (D) are correct, reflecting proper understanding.
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Which client is most at risk for methicillin-resistant Staphylococcus aureus infection?
- A. 15-year-old student athlete in the emergency department with a closed femur fracture
- B. 46-year-old client on the medical-surgical unit after a laparoscopic appendectomy
- C. 72-year-old client who received a permanent pacemaker 24 hours ago
- D. 80-year-old client with a hemodialysis catheter who lives in a long-term care facility
Correct Answer: D
Rationale: The 80-year-old with a hemodialysis catheter in a long-term care facility (D) is at highest risk for MRSA due to invasive devices, frequent healthcare exposure, and communal living. Others (A, B, C) have lower risk profiles.
The nurse is caring for a client with cholelithiasis and acute cholecystitis. The client suddenly vomits 250 mL of greenish-yellow emesis and reports severe right upper quadrant pain with radiation to the right shoulder. Which intervention would have the highest priority?
- A. Administer promethazine suppository
- B. Initiate NPO status
- C. Insert nasogastric tube set to low suction
- D. Obtain prescription for pain medication
Correct Answer: B
Rationale: Acute cholecystitis with vomiting and severe pain suggests gallbladder inflammation or obstruction, requiring immediate cessation of oral intake (NPO status, B) to prevent further stimulation and complications like perforation. Promethazine (A) and pain medication (D) are supportive but secondary. A nasogastric tube (C) may be considered later but is not the priority.
A 3 year-old child has tympanostomy tubes in place. The child's parent asks the nurse if he can swim in the family pool. The best response from the nurse is
- A. Your child should not swim at all while the tubes are in place.'
- B. Your child may swim in your own pool but not in a lake or ocean.'
- C. Your child may swim if he wears ear plugs.'
- D. Your child may swim anywhere.'
Correct Answer: C
Rationale: Water should not enter the ears. Children should use ear plugs when bathing or swimming and should not put their heads under the water.
A student nurse performs morning rounds and obtains a urine specimen from a client with methicillin-resistant Staphylococcus aureus who is in contact precautions. The nurse preceptor intervenes when the student performs which action?
- A. Cleans the stethoscope with 2% chlorhexidine solution before removing it from the room
- B. Removes the urine specimen cup from the room in a sealed, leak-proof bag
- C. Scrubs the Foley catheter collection port with alcohol for 15 seconds before withdrawing a urine specimen
- D. Uses an alcohol-based hand antiseptic after removing gloves
Correct Answer: A
Rationale: Chlorhexidine (A) is not standard for stethoscope cleaning in contact precautions; alcohol or approved disinfectants are used to prevent MRSA transmission. Sealed bags for specimens (B), scrubbing the port (C), and hand hygiene (D) are correct actions to maintain infection control.
A patient has recently been prescribed Lidocaine Hydrochloride. Which of the following symptoms may occur with over dosage?
- A. Memory loss and lack of appetite
- B. Confusion and fatigue
- C. Heightened reflexes
- D. Tinnitus and spasticity
Correct Answer: B
Rationale: Lidocaine Hydrochloride can cause fatigue and confusion if an over dosage occurs.