Nokea
The parents of a child with mumps express concern that their child will develop orchitis as a result of having mumps. What characteristic of this complication should the nurse discuss with the parents?
- A. Fever
- B. Facial swelling
- C. Swollen glands
- D. Difficulty urinating
Correct Answer: A
Rationale: Unilateral orchitis occurs more frequently than bilateral orchitis. About 1 week after the appearance of parotitis, there is an abrupt onset of testicular pain, tenderness, fever, chills, headache, and vomiting. The affected testicle becomes red, swollen, and tender. Atrophy, resulting in sterility, occurs only in a small number of cases. Facial swelling and swollen glands normally occur in mumps. Difficulty urinating is not a sign of this complication.
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The nurse is assessing a client with a suspected diverticulitis. Which of the following findings is most indicative of this condition?
- A. Left lower quadrant pain.
- B. Right upper quadrant pain.
- C. Soft, nontender abdomen.
- D. Frequent loose stools.
Correct Answer: A
Rationale: Left lower quadrant pain is a hallmark sign of diverticulitis due to inflammation of diverticula in the sigmoid colon.
The nurse is caring for a client with a history of epilepsy who is prescribed valproic acid (Depakene). Which of the following laboratory tests should the nurse monitor?
- A. Liver function tests.
- B. Renal function tests.
- C. Complete blood count.
- D. Blood glucose levels.
Correct Answer: A
Rationale: Valproic acid can cause hepatotoxicity, requiring regular monitoring of liver function tests.
Which of these choices contains the six elements necessary for malpractice?
- A. Causation, foreseeability, damages to the patient, a duty that was owed to the client and this duty was breached, and direct rather than indirect harm to the client.
- B. Causation, foreseeability, damages to the patient, a duty that was owed to the client and this duty was breached, and direct and/or indirect harm to the client.
- C. Causation, correlation, damages to the patient, a duty that was owed to the client and this duty was breached, and direct and/or indirect harm to the client.
- D. Causation, foreseeability, damages to the patient, a duty that was owed to the client and this duty was breached, and a medical license.
Correct Answer: A
Rationale: The six elements of malpractice are duty owed, breach of duty, foreseeability, causation, direct harm, and damages . Indirect harm or correlation are not standard elements, and a medical license is irrelevant.
A client wanders in and out of other clients' rooms, taking their possessions while singing to himself and then giggling for no apparent reason. The nurse reacts therapeutically by taking which action?
- A. Putting arms around the client, saying, 'You're okay. You just need a hug.'
- B. Saying, 'I can see you are very anxious today. Let's go and play the piano.'
- C. Taking the client to the seclusion room until he cooperates with unit rules.
- D. Taking the client to the lounge and saying, 'Sit here and try to behave yourself.'
Correct Answer: B
Rationale: The use of a defense mechanism allows a person to avoid the painful experience of anxiety or transform it into a more tolerable symptom, such as regression. Regression allows the threatened client to move backward developmentally to a stage in which more security is felt. The recognition of regression is a signal that the client feels anxious. The correct option will help the client feel less anxious. A hug does not address the client's anxiety. The remaining options are restrictive and degrading.
The nurses in the neonatal intensive care unit are not identifying important clinical changes in the clients that need to be documented. The unit director should initiate which of the following actions? Select all that apply.
- A. Identify the problem at a staff meeting without placing blame on any individual or group.
- B. Ask the unit staff to develop a plan that they think will solve this problem.
- C. Ask an experienced nurse to spend time reorienting newer staff members.
- D. Collaborate with the staff development educator to develop a plan.
- E. Ask the neonatologist to give a presentation about assessing newborns.
Correct Answer: A,C,D,E
Rationale: Addressing the issue without blame, involving staff in solutions, reorienting newer staff, collaborating with educators, and arranging expert presentations are all effective strategies to improve documentation.