Nokea
The nurse is reinforcing teaching with a client in the postpartum period who is breastfeeding and has breast engorgement. Which of the following information should the nurse include?
- A. Apply ice packs to your breasts for 15 to 20 minutes before breastfeeding
- B. Allow your baby to nurse for at least 10 to 15 minutes on each breast
- C. Temporarily decrease the frequency of your breastfeeding
- D. Avoid taking NSAIDs for discomfort while breastfeeding
Correct Answer: B
Rationale: Nursing for 10-15 minutes per breast relieves engorgement by emptying milk ducts. Ice packs are used after, not before, feeding; decreasing frequency worsens engorgement; and NSAIDs are safe for breastfeeding.
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A 79-year-old client asks the nurse if she needs any shots. She reports having had 'all the usual shots when I was younger.' Which immunization is most important for this person to receive?
- A. DPT
- B. MMR
- C. Pneumovax
- D. HiB
Correct Answer: C
Rationale: Pneumovax is critical for adults over 65 to prevent pneumococcal pneumonia, a significant risk in the elderly.
All of the following need to be done. Which should the nurse do first?
- A. A client who had surgery earlier today asks for pain medication.
- B. A client who is two days postoperative needs a dressing change.
- C. A client who had a cerebrovascular accident needs a bed bath.
- D. A client scheduled for surgery tomorrow needs an enema.
Correct Answer: A
Rationale: Pain management for a client post-surgery today is a priority to promote comfort and recovery. Dressing changes, bed baths, and preoperative enemas are less urgent.
Which incidence should be documented on an unusual incident report?
- A. The client leaves the hospital against the doctor's advice.
- B. The client develops a fever after receiving a blood transfusion.
- C. The client reports an upset stomach after taking an antibiotic.
- D. The client falls in her bathroom.
Correct Answer: D
Rationale: A fall is an unusual incident requiring documentation due to potential injury and liability. Leaving AMA, transfusion fever, or upset stomach are notable but less likely to require an incident report.
Damage to the VIII cranial nerve results in:
- A. Air conduction loss
- B. Sensorineural loss
- C. Mixed hearing disorders
- D. Tinnitus
Correct Answer: B
Rationale: The VIII cranial nerve (vestibulocochlear) is responsible for hearing and balance; damage causes sensorineural hearing loss, affecting the inner ear or nerve pathways.
The nurse monitors a child who has been treated for an acute asthma exacerbation. Which finding is the best indicator that treatment has been effective?
- A. Episodes of spasmodic coughing have decreased
- B. No wheezes are audible on chest auscultation
- C. Oxygen saturation has increased from 88% to 93%
- D. Peak expiratory flow rate has dropped from 212 L/min to 127 L/min
Correct Answer: B
Rationale: Absence of wheezes indicates open airways, the primary goal of asthma treatment. Reduced coughing and improved oxygen saturation are positive but less specific than clear lungs.