Nokea
The physician has ordered Dextrose 5% in normal saline for an infant admitted with gastroenteritis. The advantage of administering the infant's IV through a scalp vein is:
- A. The infant can be held and comforted more easily.
- B. Dextrose is best absorbed from the scalp veins.
- C. Scalp veins do not infiltrate like peripheral veins.
- D. There are few pain receptors in the infant's scalp.
Correct Answer: A
Rationale: Scalp veins allow easier access for IV administration in infants, and the site is more accessible for comforting the infant without disturbing the IV line.
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A client has increasing pain in both hands. On examination, the nurse notes that the metacarpophalangeal and proximal interphalangeal joints are enlarged and swollen, swanneck deformity is evident, and the fingers on both hands show ulnar deviation. These findings are consistent with which of the following disorders?
- A. Osteoarthritis
- B. Rheumatoid arthritis
- C. Gouty arthritis
- D. Psoriatic arthritis
Correct Answer: B
Rationale: Swanneck deformity, ulnar deviation, and swollen MCP/PIP joints are classic for rheumatoid arthritis (B). Osteoarthritis (A) affects distal joints, gout (C) causes tophi, and psoriatic arthritis (D) involves skin lesions.
A client in ICU has a chest tube, and the nurse is assessing the chest tube drainage system. The nurse notices intermittent bubbling in the water seal chamber. What action should the nurse take?
- A. clamp the chest tube and call for help
- B. document the findings in the client chart
- C. document an air leak and notify the physician
- D. call the physician to report the findings
Correct Answer: B
Rationale: Intermittent bubbling in the water seal chamber is normal during inspiration/expiration or coughing, indicating a patent system. It should be documented as a normal finding.
A nurse reviewed a client's progress in smoking cessation, praising the client for being successful but suggesting the client might stop having coffee in the morning since that caused an urge to smoke. Following this session, the client appeared upset and complained that the nurse believed she was doing poorly because she wanted a cigarette with her morning coffee. Which type of cognitive distortion is the client exhibiting?
- A. Overgeneralization
- B. Mental filter
- C. All-or-nothing thinking
- D. Magnification
Correct Answer: B
Rationale: Mental filter (B) involves focusing only on the negative (nurse's suggestion) and ignoring praise, leading to the client's misinterpretation.
An adolescent client hospitalized with anorexia nervosa is described by her parents as 'the perfect child.' When planning care for the client, the nurse should:
- A. Allow her to choose what foods she will eat
- B. Provide activities to foster her self-identity
- C. Encourage her to participate in morning exercise
- D. Provide a private room near the nurse's station
Correct Answer: B
Rationale: Activities fostering self-identity address the underlying issues of low self-esteem and perfectionism common in anorexia nervosa.
A 3-year-old child had a PPD skin test 2 days ago. When the mother brings the child back to the clinic to have the nurse check the results, the nurse notes a 10 mm area of induration. This is considered
- A. an inconclusive skin test.
- B. a positive skin test.
- C. a negative skin test.
- D. too early to determine the results.
Correct Answer: B
Rationale: A 10 mm induration 48-72 hours post-PPD is positive in children, indicating TB exposure, especially in high-risk groups.