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When reviewing car seat use with the parents of a 1-month-old infant, which of the following instructions should the nurse include?
- A. Use a car seat that has a three-point harness system.
- B. Position the car seat so that the infant is rear-facing.
- C. Secure the car seat in the front passenger seat of the vehicle.
- D. Convert to a booster seat after 12 months.
Correct Answer: B
Rationale: The correct instruction for car seat use with a 1-month-old infant is to position the car seat so that the infant is rear-facing. This orientation provides the safest option for infants as it supports their head, neck, and spine. While using a car seat with a three-point harness system is appropriate for infants, placing the car seat in the front passenger seat is not recommended due to the presence of airbags, which can pose a risk to the infant in the event of deployment. Additionally, transitioning to a booster seat is not suitable at 12 months; infants should remain in rear-facing car seats until they outgrow the seat's height or weight limits, typically around 2 years of age.
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A dying client is coping with feelings regarding impending death. The nurse bases care on the theory of death and dying by K¼bler-Ross. During which stage of grieving should the LPN/LVN primarily use nonverbal interventions?
- A. Anger
- B. Denial
- C. Bargaining
- D. Acceptance
Correct Answer: D
Rationale: Nonverbal interventions are primarily used during the acceptance stage according to K¼bler-Ross's theory of death and dying. During the acceptance stage, the individual is more likely to be reflective and less communicative, making nonverbal interventions more effective. Choices A, B, and C are incorrect because anger, denial, and bargaining are stages that precede the acceptance stage in K¼bler-Ross's model, where verbal communication and processing emotions play a more significant role.
A client is receiving morphine via PCA infusion device after abdominal surgery. Which of the following statements indicates that the client knows how to use the device?
- A. I'll wait to use the device until it's absolutely necessary.
- B. I'll be careful about pushing the button too much to avoid an overdose.
- C. I should tell the nurse if the pain doesn't stop while I am using this device.
- D. I will ask my adult child to push the dose button when I am sleeping.
Correct Answer: C
Rationale: Choice C is the correct answer because it demonstrates that the client understands the importance of communicating with the nurse if the pain persists while using the PCA device. This is crucial as it ensures proper pain management and monitoring. Choices A and B are incorrect because delaying the use of the device until necessary or being cautious about pushing the button too much do not necessarily reflect understanding of using the PCA device effectively. Choice D is incorrect as having someone else, like an adult child, push the dose button goes against the principle of the client self-administering the medication through the PCA device.
A patient has damage to the cerebellum. Which disorder is most important for the nurse to assess?
- A. Impaired balance
- B. Hemiplegia
- C. Muscle sprain
- D. Lower extremity paralysis
Correct Answer: A
Rationale: When the cerebellum is damaged, it leads to impaired balance. The cerebellum plays a crucial role in coordinating movements and maintaining balance. Therefore, assessing the patient's balance is essential in determining the extent of cerebellar damage. Options B, C, and D are incorrect because hemiplegia refers to paralysis of one side of the body, muscle sprain is a soft tissue injury, and lower extremity paralysis involves loss of function in the lower limbs. These conditions are not directly associated with damage to the cerebellum.
The healthcare provider is preparing to administer a subcutaneous injection of heparin. Which site is most appropriate for the healthcare provider to use?
- A. Deltoid muscle
- B. Ventrogluteal site
- C. Abdomen
- D. Dorsogluteal site
Correct Answer: C
Rationale: The abdomen is the most appropriate site for administering subcutaneous heparin injections. The abdomen has a layer of subcutaneous fat and a good blood supply, making it an ideal site for subcutaneous injections. Using the deltoid muscle for heparin injections is not appropriate as it is typically used for intramuscular injections. The ventrogluteal site is more suitable for intramuscular injections rather than subcutaneous injections. The dorsogluteal site is no longer recommended for injections due to the risk of injury to the sciatic nerve.
A client requires an NG tube for stomach decompression. Which of the following actions should the nurse take when inserting the NG tube?
- A. Help the client take sips of water to promote insertion of the NG tube.
- B. Insert the tube without asking the client to swallow.
- C. Advance the tube continuously without pausing.
- D. Use a large-bore tube for insertion.
Correct Answer: A
Rationale: The correct action when inserting an NG tube is to help the client take sips of water. This helps facilitate the insertion of the tube by promoting swallowing and passage through the esophagus. Asking the client to swallow assists in guiding the tube into the stomach. Inserting the tube without asking the client to swallow may lead to incorrect placement or discomfort. Advancing the tube continuously without pausing can cause the tube to coil in the esophagus, leading to complications. Using a large-bore tube for insertion is unnecessary and may increase the risk of injury or discomfort for the client.