Nokea
The nurse is to administer digoxin (Lanoxin) elixir to a 6-month-old with a congenital heart defect. The nurse auscultates an apical pulse rate of 100. The nurse should:
- A. Record the heart rate and call the physician
- B. Record the heart rate and administer the medication
- C. Administer the medication and recheck the heart rate in 15 minutes
- D. Hold the medication and recheck the heart rate in 30 minutes
Correct Answer: B
Rationale: For a 6-month-old, an apical pulse of 100 beats per minute falls within the normal range (80-150 bpm), indicating it's safe to administer digoxin, a cardiac glycoside for heart defects, without delay. Recording and calling the physician or holding the dose isn't warranted unless the rate drops below 90-100 bpm (per pediatric guidelines). Rechecking post-administration isn't standard unless symptoms arise. Nurses document and proceed, ensuring timely therapy while monitoring for toxicity signs like bradycardia later.
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Culture media is sterilized by which of the following method?
- A. Autoclaving
- B. Boiling
- C. Hot air oven
- D. Ionizing radiation
Correct Answer: A
Rationale: Sterilization of culture media is critical in microbiology to eliminate contaminants. Autoclaving (choice A) uses moist heat under pressure (typically 121°C at 15 psi for 15-20 minutes) to kill bacteria, spores, and viruses, making it the gold standard for sterilizing liquid media like agar or broth. Boiling (choice B) at 100°C can kill vegetative bacteria but not heat-resistant spores, rendering it inadequate for complete sterilization. Hot air oven (choice C) employs dry heat (160-170°C for 2 hours) and is suitable for glassware, not liquid media, as it may evaporate or degrade nutrients. Ionizing radiation (choice D) is effective for heat-sensitive materials (e.g., plastics), but it's less common for routine media preparation due to cost and equipment needs. Autoclaving is the correct answer (A) because it ensures thorough sterilization of culture media, a process nurses and lab personnel rely on to maintain aseptic conditions for accurate diagnostic cultures.
Which of the following theorists stressed energy fields in their nursing theory?
- A. Dorothea Orem
- B. Helen Neuman
- C. Rosemarie Parse
- D. Martha E. Rogers
Correct Answer: D
Rationale: Martha E. Rogers' nursing theory, the Science of Unitary Human Beings, uniquely stresses energy fields, viewing humans and their environments as dynamic, interconnected patterns. Unlike Orem's self-care focus, Neuman's systems approach, or Parse's human becoming perspective, Rogers emphasizes energy exchange like therapeutic touch affecting health. For instance, a nurse might consider environmental energy disruptions when a client's recovery stalls, applying this abstract concept practically. This distinguishes her theory, integrating physics-like principles into nursing to enhance holistic understanding and care.
He proposed the theory of morality that is based on MUTUAL TRUST
- A. Freud
- B. Erikson
- C. Kohlberg
- D. Peters
Correct Answer: C
Rationale: Lawrence Kohlberg's moral development theory, from the 1950s, hinges on mutual trust e.g., a child learns fairness through reciprocal relationships. Freud's psychoanalysis, Erikson's psychosocial stages, and Peters' principle-based morality differ. Kohlberg's stages premoral (reward/punishment), conventional (social norms), post-conventional (personal ethics) explain moral growth, influencing nursing ethics education on trust-based patient interactions.
A client with hypertension is being taught about the DASH diet. Which of the following statements by the client indicates an understanding of the teaching?
- A. I should increase my intake of sodium-rich foods.
- B. I should decrease my intake of potassium-rich foods.
- C. I should increase my intake of fruits and vegetables.
- D. I should decrease my intake of whole grains.
Correct Answer: C
Rationale: The correct answer is C. The Dietary Approaches to Stop Hypertension (DASH) diet is recommended for managing hypertension. Increasing the intake of fruits and vegetables is a key component of the DASH diet as these foods are rich in nutrients that can help lower blood pressure levels. Choices A, B, and D are incorrect because they go against the principles of the DASH diet, which focuses on reducing sodium intake, increasing potassium-rich foods, and consuming whole grains.
During an abdominal assessment, what is the correct sequence of steps for a healthcare provider to follow?
- A. Inspection, percussion, palpation, auscultation
- B. Percussion, auscultation, inspection, palpation
- C. Auscultation, palpation, inspection, percussion
- D. Inspection, auscultation, percussion, palpation
Correct Answer: D
Rationale: During an abdominal assessment, the correct sequence of steps is inspection, auscultation, percussion, and palpation. This sequence is followed to prevent altering bowel sounds. Inspection allows for visual observation, followed by auscultation to listen for bowel sounds without causing disturbance, percussion to assess for tympany or dullness, and finally palpation to feel for any abnormalities or tenderness. Choice A is incorrect because palpation should come after percussion. Choice B is incorrect as auscultation should be performed after inspection. Choice C is incorrect because palpation should be the final step after percussion.