Nokea
The parents of a child who is in for a 1-year well-baby check ask what immunizations the child needs. The nurse checks the child's record and determines that the child has had immunizations as recommended during the first year. What should the nurse reply?
- A. MMR and rotavirus
- B. Hepatitis B and polio
- C. Haemophilus influenzae type B (HiB) and varicella
- D. Pneumococcal and meningococcal
Correct Answer: C
Rationale: At 1 year, per CDC guidelines, children typically receive MMR, varicella, and HiB (final dose), assuming prior vaccinations are complete. Rotavirus, hepatitis B, polio, pneumococcal, and meningococcal are given at other ages.
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An adult is admitted to the nursing care unit. He begs the nurse to give him a laxative. Which data in the admission assessment contraindicates administration of a laxative?
- A. The client has not had a bowel movement for two days.
- B. The client has a temperature of 100.8°F.
- C. The client is nauseated and vomited before admission.
- D. The client has right lower quadrant abdominal pain.
Correct Answer: D
Rationale: Right lower quadrant pain may indicate appendicitis or other acute conditions; laxatives could worsen the condition, risking perforation. Two days without a bowel movement, mild fever, or nausea do not contraindicate laxatives.
A client is being followed in the rape-crisis clinic one week after being assaulted. The client is currently taking Xanax 0.25 mg PO q6h for anxiety. Which of the following statements, if made by the client to the nurse, reflects a correct understanding of this medication?
- A. I can take it whenever I feel upset.
- B. I should not take this with anything but water.
- C. I guess I need to stop drinking white wine.
- D. This medication will help me forget and go on.
Correct Answer: C
Rationale: Alcohol, including white wine, potentiates Xanax’s sedative effects, increasing risks. Avoiding it shows understanding. Options A, B, and D are incorrect.
The nurse is teaching a client with a new diagnosis of type 2 diabetes about metformin (Glucophage). Which of the following statements by the client indicates a need for further teaching?
- A. I should take this medication with meals.
- B. I should report nausea to my doctor.
- C. I should avoid drinking alcohol.
- D. I should stop this medication if my blood sugar is normal.
Correct Answer: D
Rationale: Stopping metformin when blood sugar is normal is incorrect, as type 2 diabetes requires ongoing treatment to maintain control. Options A, B, and C are correct: taking with meals reduces GI upset, nausea is a side effect, and alcohol increases lactic acidosis risk.
The nurse is caring for an adult who is enrolled in a study involving an experimental drug. The client says to the nurse, 'I don't think I can stand the vomiting anymore. I think it is due to the drug I am taking. If only I could get out of this study I signed up for. That was a really stupid thing I did when I signed up for the study.' What information must the nurse include when responding to the client?
- A. If the client signed the proper forms, the client is committed to the study.
- B. Persons who have signed up for a study may opt out of the study at any time.
- C. The person should discuss his/her concerns with the researchers.
- D. Inform the client that there are drugs that can control nausea.
Correct Answer: B
Rationale: Participants can withdraw from research studies at any time, per ethical research guidelines, ensuring autonomy and safety.
A bipolar patient refuses to put down the mop that he is swinging to threaten other patients and staff.
What information is MOST important for the nurse to consider before administering a PRN IM dose of lorazepam (Ativan)?
- A. The patient is harmful to himself.
- B. The patient is psychotic.
- C. A restrictive intervention failed.
- D. The patient is harmful to others.
Correct Answer: C
Rationale: Strategy: Think about each answer choice. (1) use the least restrictive interventions in ascending order (2) use the least restrictive interventions in ascending order (3) correct-use the least restrictive interventions in ascending order (4) use the least restrictive interventions in ascending order