Nokea
The physician is calling in an order for ampicillin for a neonate. The nurse should do which of the following? Select all that apply.
- A. Write down the order.
- B. Ask the physician to come to the hospital and write the order on the chart.
- C. Repeat the order to the physician over the telephone.
- D. Ask the physician to confirm that the order is correct.
- E. Ask the nursing supervisor to cosign the telephone order as transcribed by the nurse.
Correct Answer: A,C,D
Rationale: Writing the order, repeating it back, and confirming with the physician ensure accuracy and safety for a telephone order.
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When obtaining the nursing history of a client who has diabetes mellitus, the nurse should assess the client for which of the following early symptom of renal insufficiency?
- A. Polyuria
- B. Oliguria
- C. Anuria
- D. Dysuria
Correct Answer: A
Rationale: Polyuria is an early symptom of renal insufficiency in diabetes due to impaired kidney function affecting urine concentration. Oliguria, anuria, and dysuria are later or less specific.
When giving a change of shift report, which of the following statements by the nurse is not appropriate?
- A. Randi Smith is a 38-year-old female client of Dr. Born with cholecystitis and cholelithiasis.'
- B. Mrs. Jones' pain is best relieved in the left lateral Sims position.'
- C. Mr. Levi is just contrary today and nothing is going to please him.'
- D. Mr. Emmert was able to walk around the unit twice today with no complaint of dizziness.'
Correct Answer: C
Rationale: Subjective statements like 'contrary' are inappropriate in a professional report, as they lack objectivity and clinical relevance.
The nurse is teaching a client with a new diagnosis of epilepsy about safety precautions. Which of the following instructions is most important?
- A. Avoid swimming alone.
- B. Take medications at bedtime only.
- C. Use a soft toothbrush.
- D. Limit fluid intake.
Correct Answer: A
Rationale: Avoiding swimming alone is critical for safety in epilepsy to prevent drowning during a seizure.
A client with pneumonia is receiving oxygen at 2 L/min via nasal cannula. The nurse notes a respiratory rate of 30 breaths/min and oxygen saturation of 88%. What should the nurse do first?
- A. Increase the oxygen to 4 L/min
- B. Notify the physician
- C. Encourage deep breathing exercises
- D. Reposition the client to semi-Fowler's
Correct Answer: B
Rationale: An oxygen saturation of 88% and tachypnea indicate worsening hypoxia, requiring immediate physician notification for further orders. Increasing oxygen or repositioning may help but requires a prescription.
A 15-month-old child is admitted to the pediatric unit with the diagnosis of pneumonia and is placed in a mass test. Which following toys would be appropriate for this child?
- A. A pull toy.
- B. Storybooks.
- C. Crayons and paper.
- D. Plastic blocks.
Correct Answer: D
Rationale: Plastic blocks are safe and age-appropriate for a 15-month-old, promoting fine motor skills without posing a choking hazard or requiring mobility restricted by a mist tent.