Nokea
A newborn is to be discharged in the AM.
The nurse should teach the child's mother to perform which of the following actions?
- A. Apply a sterile gauze dressing with petroleum jelly to the cord.
- B. Position the diaper over the umbilicus to keep it dry.
- C. Clean the cord several times a day and expose it to air frequently.
- D. Apply erythromycin ointment to the cord several times a day.
Correct Answer: C
Rationale: Strategy: The topic of the question is unstated. (1) appropriate for circumcision (2) will keep the area moist; the diaper should be placed below the umbilicus (3) correct-encourages drying and helps to prevent infection (4) antibiotic ointment is unnecessary
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The nurse is caring for a client who is postoperative day 1 after a pancreaticoduodenectomy (Whipple procedure). Which of the following findings should the nurse report immediately?
- A. Pain at the incision site.
- B. Temperature of 100.8°F (38.2°C).
- C. Nasogastric tube output of 200 mL.
- D. Urine output of 40 mL/hour.
Correct Answer: B
Rationale: A temperature of 100.8°F suggests infection, a serious post-Whipple complication. Options A, C, and D are normal.
A 16-year-old young woman is brought by her parents to the outpatient clinic for treatment of pelvic inflammatory disease (PID). While the nurse obtains a history, the client says bitterly, 'My parents are mean and don't really care about me.' Which of the following responses by the nurse is BEST?
- A. You feel your parents don't care about you?
- B. Your parents brought you to the clinic, didn't they?
- C. I am sure that your parents have your best interests at heart.
- D. Did you have a disagreement with your parents?
Correct Answer: A
Rationale: Reflecting the client’s feelings validates her emotions, encouraging therapeutic communication. Options B, C, and D are nontherapeutic, dismissing or challenging her statement.
The client taking allopurinol (Zyloprim) should be taught to:
- A. Drink approximately eight glasses of water per day.
- B. Avoid the intake of fruits.
- C. Allow 6 weeks for the drug to work.
- D. Eat foods containing purine.
Correct Answer: A
Rationale: Allopurinol prevents uric acid buildup, and adequate hydration (eight glasses of water) reduces kidney stone risk. Fruits are not restricted, the drug works sooner, and purine foods should be limited.
An adult who is receiving methotrexate for rheumatoid arthritis asks the nurse why she is receiving methotrexate. What should the nurse include when responding?
- A. Methotrexate is given to help control the pain of rheumatoid arthritis.
- B. The drug is antipyretic and helps control the fevers associated with rheumatoid arthritis.
- C. Rheumatoid arthritis is an autoimmune disorder. Methotrexate is an immunosuppressant.
- D. The drug helps to repair cartilage that is damaged when a person has rheumatoid arthritis.
Correct Answer: C
Rationale: Methotrexate suppresses the autoimmune response in rheumatoid arthritis, reducing joint inflammation and damage. It is not primarily for pain, fever, or cartilage repair.
The nurse is aware that Rh immune globulin (RhoGAM) is administered.
The nurse is aware that Rh immune globulin (RhoGAM) is administered to prevent complications in which of the following situations?
- A. The baby is Rh-negative, the mother is Rh-negative, and the father is Rh-positive.
- B. The mother is Rh-negative, the baby is Rh-positive, and there is a negative direct Coombs'.
- C. The mother is Rh-positive and previously sensitized, and the baby is Rh-negative.
- D. The mother is Rh-positive, the baby is Rh-negative, and there is a history of one incomplete pregnancy.
Correct Answer: B
Rationale: Strategy: Think about each answer choice. (1) if both mother and baby are Rh-negative, there is no problem (2) correct-RhoGAM is given to an Rh-negative mother who delivers an Rh-positive baby when baby has a negative Coombs' Test (3) medication is not given if the mother has been sensitized by a previous pregnancy (4) there is no incompatibility here, but the mother needs to be evaluated regarding sensitization in the incomplete pregnancy