Nokea
To treat cervical cancer, a client has had an applicator of radioactive material placed in the vagina. Which observation by the nurse indicates a radiation hazard?
- A. The client is maintained on strict bed rest
- B. The head of the bed is at 30-degree angle
- C. The client receives a complete bed bath each morning
- D. The nurse checks the applicator's position every 4 hours
Correct Answer: B
Rationale: Keeping the head of the bed at a 30-degree angle can dislodge the applicator of radioactive material placed in the vagina. When caring for a client with a radioactive applicator, it is important to ensure that the position of the applicator is maintained to prevent radiation exposure to staff and other clients. This can be achieved by keeping the head of the bed flat without elevation. The other options are appropriate measures in caring for a client with a radioactive applicator.
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Which of the following tests would the nurse use as an initial screening test to determine hearing loss?
- A. Romberg test
- B. Caloric test
- C. Otoscopic examination
- D. Whisper voice test
Correct Answer: D
Rationale: The nurse would use the whisper voice test as an initial screening test to determine hearing loss. This test involves the nurse whispering a series of words or numbers from a distance behind the patient to assess their ability to hear and repeat the whispered words accurately. This test is quick, easy, and can be performed in a quiet environment without the need for special equipment, making it an effective initial screening tool for hearing loss. The Romberg test assesses balance, the caloric test evaluates vestibular function, and the otoscopic examination is used to assess the external ear canal and eardrum, but none of these tests specifically assess hearing loss.
During the physical examination of a client for a possible neurologic disorder, how can the nurse examine the client for stiffness and rigidity of the neck?
- A. By positioning the client flat on bed for at least 3 hrs
- B. By moving the head and chin of the client toward the chest
- C. By asking the client to bend and pick up small and large objects on the floor
- D. By introducing a painful stimulus on the neck
Correct Answer: B
Rationale: The nurse can examine the client for stiffness and rigidity of the neck by moving the head and chin of the client toward the chest. This maneuver, known as neck flexion, assesses the resistance and presence of stiffness in the neck muscles. Stiffness and rigidity of the neck muscles may suggest conditions such as meningitis, cervical dystonia, or other neurologic disorders. It is important for the nurse to perform this examination maneuver carefully to avoid causing discomfort or injury to the client.
The MOST appropriate answer to why infants cry in response to another infant's cry is
- A. an early sign of empathy development
- B. a sign of good hearing reflex
- C. a startle reflex
- D. an early sign of fear development
Correct Answer: A
Rationale: Empathy begins developing early, though rudimentary.
A 2-month-old premature infant born at 30 weeks gestation is scheduled for an inguinal hernia repair. Which of the following preoperative findings would BEST predict an increased risk of postoperative apnea?
- A. Hemoglobin 7 gm/dL
- B. Glucose 61 mg/dL
- C. Room air SpO2 92%
- D. N/A
Correct Answer: A
Rationale: Low hemoglobin levels in a premature infant can increase the risk of postoperative apnea due to reduced oxygen-carrying capacity.
A client tells the nurse that she has been working hard for the last 3 months to control her type 2 diabetes mellitus with diet and exercise. To determine the effectiveness of the client's efforts, the nurse should check:
- A. Urine glucose level
- B. Serum fructosamine level
- C. Fasting blood glucose level
- D. Glycosylated hemoglobin level
Correct Answer: D
Rationale: Checking the glycosylated hemoglobin (HbA1c) level is the most appropriate way to determine the effectiveness of the client's efforts to control type 2 diabetes mellitus over the past few months. HbA1c provides an average of the blood glucose levels over the past 2-3 months, reflecting how well the client has been managing their diabetes. This test is not affected by recent food intake or physical activity, making it a reliable indicator of long-term glucose control. Unlike fasting blood glucose levels or urine glucose levels, which can fluctuate throughout the day, HbA1c gives a more comprehensive view of glucose control and helps guide treatment decisions.