Nokea
When interviewing the parents of a child with asthma, it is most important to assess the child's environment for what factor?
- A. Household pets
- B. New furniture
- C. Lead based paint
- D. Plants such as cactus
Correct Answer: A
Rationale: Animal dander is a very common allergen affecting persons with asthma. Other triggers may include pollens, carpeting and household dust.
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The nurse is reinforcing teaching with a client who has a new prescription for sublingual nitroglycerin. Which of the following statements by the client would indicate a correct understanding of the teaching?
- A. I am able to take nitroglycerin with my prescribed vardenafil
- B. I will stop taking nitroglycerin if I experience a headache or flushing
- C. I can keep a few nitroglycerin tablets in a plastic bag in case I need them while I am away from home
- D. I should take 1 nitroglycerin tablet every 5 minutes, up to 3 doses, if I am experiencing chest pain
Correct Answer: D
Rationale: Many clients lack knowledge about the proper administration, storage, and side effects of nitroglycerin (NTG). Client teaching can prevent many emergency department visits for chest pain caused by stable angina. Clients should be taught to take 1 tablet every 5 minutes, up to 3 doses. Emergency medical services should be called if pain does not improve or worsens 5 minutes after the first tablet is taken. Previously, clients were taught to call after the third dose was taken, but new evidence suggests this causes a significant delay in treatment
The nurse is reviewing recommended dietary modifications with the parents of a 6-month-old client with phenylketonuria. Which of the following information should the nurse include? Select all that apply.
- A. A low-phenylalanine diet is required
- B. Meat and dairy products should not be introduced into the diet
- C. Phenylketonuria is self-limiting and dietary modifications are temporary
- D. Specially prepared infant formula is necessary
- E. Tyrosine should be removed from the diet
Correct Answer: A,B,D
Rationale: Phenylketonuria requires a lifelong low-phenylalanine diet, avoiding meat and dairy, and using special formula to prevent neurological damage. It is not self-limiting, and tyrosine is needed, not removed.
The nurse is assisting with an education conference for graduate nurses about infant CPR. Which of the following statements are appropriate to include in the teaching? Select all that apply.
- A. A single rescuer responding to an unwitnessed infant arrest should perform 2 minutes of CPR before retrieving a defibrillator
- B. Depth of chest compressions for infants should be half the depth of the anterior-posterior chest diameter
- C. Rescuers should place the heel of one hand on the lower sternum when delivering chest compressions to infants
- D. The ratio of chest compressions to breaths during CPR by a single rescuer is 15:2 for infants
- E. You should assess the infant’s brachial pulse for no longer than 10 seconds
Correct Answer: A,E
Rationale: Two minutes of CPR before defibrillator retrieval and assessing the brachial pulse for ≤10 seconds align with infant CPR guidelines. Compression depth is about one-third the chest, two fingers are used, and the ratio is 30:2 for a single rescuer.
A client is admitted with a head injury. Which vital sign assessment is most indicative of increased intracranial pressure?
- A. BP 120/80, pulse 120, respirations 20
- B. BP 180/98, pulse 50, temperature 102°F
- C. BP 98/60, pulse 132, temperature 97.6°F
- D. BP 170/90, pulse 80, respirations 24
Correct Answer: B
Rationale: Vital signs correlating with increased intracranial pressure are an elevated BP with a widening pulse pressure, a slow pulse rate, and an elevated temperature with involvement of the hypothalamus. Answer C relates to hypovolemia, so it is incorrect. Answers A and D do not relate to increased intracranial pressure and are therefore incorrect.
The nurse is caring for several clients who are to have diagnostic tests. Which clients will receive similar instructions?
- A. The client who is having an upper GI series and the client who is having a lower GI series
- B. The client who is having a gallbladder sonogram and the client who is having a gallbladder x-ray
- C. The client who is having a barium enema and the client who is having a colonoscopy.
- D. The client who is having a gastroscopy and the client who is having a colonoscopy.
Correct Answer: C
Rationale: A barium enema and a colonoscopy both require a clear liquid diet and full bowel prep the day before. The only difference is that the client who is having a barium enema can have red liquids and the one who is having a colonoscopy cannot. The preparation for an upper GI series is NPO after midnight the night before. There is no preparation for a gallbladder sonogram. A gallbladder x-ray requires fat restriction the day before, taking iodine dye tablets, and NPO after midnight. The preparation for a gastroscopy is NPO after midnight the night before.