When caring for a toddler with acute lymphocytic leukemia, in which of the following activities should the toddler participate?
- A. Looking at alphabet flashcards.
- B. Playing with a large plastic truck.
- C. Using scissors to cut out paper shapes.
- D. Watching a cartoon in the dayroom.
Correct Answer: B
Rationale: Toddlers with acute lymphocytic leukemia may have compromised immune systems and need to avoid activities that increase infection risk. Playing with a large plastic truck is a safe and engaging activity that does not pose a high risk of infection. This choice also promotes physical activity and creativity, which are beneficial for a toddler's development during illness.
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A client is experiencing preterm contractions and dehydration. Which of the following statements should the nurse make?
- A. Dehydration is treated with calcium supplements.
- B. Dehydration can increase the risk of preterm labor.
- C. Dehydration is associated with gastroesophageal reflux.
- D. Dehydration is caused by decreased hemoglobin and hematocrit.
Correct Answer: B
Rationale: Dehydration can lead to an imbalance in electrolytes and cause uterine irritability, potentially leading to preterm contractions. It is essential for the nurse to educate the client on the importance of adequate hydration to reduce the risk of preterm labor. The statement 'Dehydration can increase the risk of preterm labor' directly addresses the client's condition and provides relevant information for their understanding and management of the situation.
While reviewing the laboratory results of a group of clients, which infection should the nurse in a provider's office report?
- A. Herpes simplex
- B. Human papillomavirus
- C. Candidiasis
- D. Chlamydia
Correct Answer: D
Rationale: Chlamydia is a sexually transmitted infection that requires notification and intervention due to its public health implications and potential complications if left untreated. Reporting Chlamydia is crucial to initiate appropriate treatment, prevent further spread of the infection, and provide necessary counseling to affected individuals. While other infections like herpes simplex, human papillomavirus, and candidiasis are also significant, Chlamydia is particularly important to report in this context.
A healthcare professional is preparing to assess a 2-week-old newborn. Which of the following actions should the professional plan to take?
- A. Obtain the newborn's body temperature using a tympanic thermometer.
- B. FACES pain scale.
- C. Auscultate the newborn's apical pulse for 60 seconds.
- D. Measure the newborn's head circumference over the eyebrows and below the occipital prominence.
Correct Answer: C
Rationale: Assessing the apical pulse in newborns is important to evaluate their cardiac function. The normal heart rate for a newborn is typically between 100-160 beats per minute. Auscultating the apical pulse for a full 60 seconds allows for an accurate assessment of the newborn's heart rate. This is a crucial component of the newborn assessment to ensure the baby's cardiovascular system is functioning within the expected range.
A client reports that the medication the nurse is administering appears different than what they take at home. Which of the following responses should the nurse take?
- A. Did the doctor discuss with you that there was a change in this medication?
- B. I recommend that you take this medication as prescribed
- C. Do you know why this medication is being prescribed to you?
- D. I will call the pharmacist now to check on this medication
Correct Answer: A
Rationale: When a client reports that the medication appears different than what they take at home, it is crucial for the nurse to ensure the safety and accuracy of the medication being administered. The most appropriate action for the nurse to take in this situation is to call the pharmacist to verify the medication, dosage, and any potential changes. This proactive step helps prevent medication errors and ensures the client's safety and well-being.
A client is being assessed by a nurse who is 30 minutes postoperative following an arterial thrombectomy. Which of the following findings should the nurse report?
- A. Chest pain
- B. Muscle spasms
- C. Cool, moist skin
- D. Incisional pain
Correct Answer: A
Rationale: Chest pain is a critical finding postoperatively, especially after an arterial thrombectomy, as it could indicate complications like myocardial infarction or pulmonary embolism. It requires immediate attention and further evaluation. Muscle spasms, cool moist skin, and incisional pain are important to assess but not as urgent as chest pain in this scenario.
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