Nokea
The school nurse is conducting health screenings on schoolchildren. During the screening, she identifies a child with the behavioral characteristics of attention deficit disorder. Which of the following behaviors is consistent with this disorder?
- A. slow speech development
- B. overreaction to stimuli from the surroundings
- C. inability to carry on a conversation
- D. concrete thinking
Correct Answer: B
Rationale: Children with attention deficit disorder are easily distracted but are able to carry on a conversation. Concrete thinking is more indicative of age, and slow speech development has more to do with other learning disabilities.
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After 12 months of cessation of menses, which of the following assessment findings in a client who is taking hormone replacement therapy should the nurse report to the physician immediately?
- A. breast tenderness
- B. weight gain
- C. fluid retention
- D. uterine bleeding
Correct Answer: D
Rationale: Uterine bleeding on combination hormone replacement therapy, after 12 months of menses cessation, indicates an increased risk of carcinoma and should be reported to the physician immediately. Breast tenderness, weight gain, and fluid retention are all routine side effects of hormone replacement therapy. They should be noted in the record and reported to the physician, but they are not urgent.
A 50 milliliter (ml) bolus of normal saline fluid is ordered by the physician. The physician wants it to infuse in 30 minutes. The nurse should set the pump rate at:
- A. 100 ml per hour for one hour.
- B. 60 ml per hour for one-half hour.
- C. 120 ml per hour for one hour.
- D. 50 ml per hour for one hour.
Correct Answer: A
Rationale: One hundred ml in one hour equals 50 ml in 30 minutes, which is what the physician prescribed. Choice 2 is 10 ml more than the physician prescribed for 30 minutes. Choice 3 is the same as Choice 2; it is 10 ml more than the physician prescribed for 30 minutes. Choice 4 only provides 25 ml over 30 minutes, or half the volume prescribed.
A complication of total parenteral nutrition (TPN) is the development of cholestasis. What is this condition?
- A. An inflammatory process of the extrahepatic bile ducts
- B. An arrest of the normal flow of bile
- C. An inflammation of the gallbladder
- D. The formation of gallstones
Correct Answer: B
Rationale: Cholestasis from TPN is an intrahepatic interruption of bile flow, unlike cholangitis (duct inflammation), cholecystitis (gallbladder inflammation), or gallstone formation.
Which of the following motions is identified with the corresponding action? (Action: Turning palm of hand over to face in the anterior direction, dorsum of the hand is pointed downward toward the floor.)
- A. Pronation
- B. Supination
- C. Abduction
- D. Adduction
Correct Answer: B
Rationale: Supination is described as 'Holding a bowl of soup in your hand,' which matches the action of turning the palm to face anteriorly.
The physician orders the antibiotics ampicillin (Omnipen) and gentamicin (Garamycin) for a newly admitted client with an infection. The nurse should:
- A. administer both medications simultaneously.
- B. give the medications sequentially, and flush well between them.
- C. ask the physician or pharmacy which medication to give first and how long to wait before giving the other drug.
- D. start one medication now and begin the other medication in 2-4 hours.
Correct Answer: B
Rationale: A client with an infection needs both antibiotics as soon as possible. However, the pH of ampicillin is 8-10, and the pH of gentamicin is 3-5.5 (making them incompatible when given together). Flushing well between drugs is necessary.