Nokea
The physician has ordered cortisporin ear drops for a 2-year-old. To administer the ear drops, the nurse should:
- A. Pull the ear down and back
- B. Pull the ear straight out
- C. Pull the ear up and back
- D. Leave the ear undisturbed
Correct Answer: A
Rationale: For children under 3, pulling the ear down and back straightens the ear canal for proper administration of ear drops.
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A client has a rate-responsive permanent pacemaker in his upper chest. The nurse understands rate-responsive to mean which of the following?
- A. A pacemaker function prevents excessive changes in the pacing rate.
- B. The pacing rate increases above the normal pacing rate with sudden bradycardia.
- C. The pacemaker switches from atrial tracking mode to nontracking mode with atrial fibrillation.
- D. The pacing rate increases when the sensors note increased activity.
Correct Answer: D
Rationale: A rate-responsive pacemaker increases the pacing rate when sensors detect increased activity (D), mimicking normal heart rate response. Other options (A, B, C) describe different pacemaker functions.
The nurse is caring for a client after a motor vehicle accident. The client has a fractured tibia, and bone is noted protruding through the skin. Which action is of priority?
- A. Provide manual traction above and below the leg
- B. Cover the bone area with a sterile dressing
- C. Apply an ACE bandage around the entire lower limb
- D. Place the client in the prone position
Correct Answer: B
Rationale: An open fracture with protruding bone risks infection. Covering with a sterile dressing is the priority to prevent contamination. Traction or bandaging may worsen the injury.
The nurse is caring for a 42-year-old client who has a do not resuscitate (DNR) order on the chart. The client tells the nurse, 'I've changed my mind about the DNR. I would like to cancel that and be given whatever care is needed to keep me alive.' Which response by the nurse is correct?
- A. I will notify your health care provider right away.'
- B. I'm glad to hear this. You shouldn't be a DNR at your age.'
- C. Let me call your family and tell them you have changed your mind.'
- D. You cannot change a DNR once it's on your chart. It is a legal document.'
Correct Answer: A
Rationale: A DNR can be revoked by the client at any time. Notifying the provider ensures the change is documented and followed.
A client scheduled for a cardiac catheterization tells the nurse, 'My mother died during this same procedure 10 years ago. I'm afraid the same thing will happen to me.' Which of the following responses by the nurse is the most appropriate?
- A. It's normal to be scared. You are safe here. Let's discuss the procedure.
- B. I'll ask the cardiologist to come and speak with you about your concerns.
- C. We have the best outcomes of any facility in the area for this procedure.
- D. Don't worry. The procedure has improved a lot in the last 10 years.
Correct Answer: A
Rationale: Acknowledging the client’s fear and discussing the procedure provides reassurance and addresses concerns therapeutically.
A client with rheumatoid arthritis is beginning to develop flexion contractures of the knees. The nurse should tell the client to:
- A. Lie prone and let her feet hang over the mattress edge
- B. Lie supine, with her feet rotated inward
- C. Lie on her right side and point her toes downward
- D. Lie on her left side and allow her feet to remain in a neutral position
Correct Answer: A
Rationale: Lying prone with feet hanging over the mattress edge promotes knee extension, helping to prevent or reduce flexion contractures in rheumatoid arthritis.