Nokea
When teaching a 10 year-old child about their impending heart surgery, which form of explanation meets the developmental needs of this age child?
- A. Provide a verbal explanation just prior to the surgery
- B. Provide the child with a booklet to read about the surgery
- C. Introduce the child to another child who had heart surgery 3 days ago
- D. Explain the surgery using a model of the heart
Correct Answer: D
Rationale: Explain the surgery using a model of the heart. According to Piaget, the school age child is in the concrete operations stage of cognitive development. Using a model to explain the surgery meets the child’s developmental needs for concrete and visual learning.
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Which of these clients would be the highest priority for the nurse to assign to a private room?
- A. A client with a new diagnosis of tuberculosis
- B. A client with a urinary tract infection
- C. A client post-appendectomy with a surgical site infection
- D. A client with seasonal influenza
Correct Answer: A
Rationale: A client with tuberculosis requires a private room with negative pressure to prevent airborne transmission of the disease.
A client with congestive heart failure is newly admitted to home health care. The nurse discovers that the client has not been following the prescribed diet. What would be the most appropriate nursing action?
- A. Discharge the client from home health care because of noncompliance
- B. Notify the provider of the client's failure to follow prescribed diet
- C. Discuss diet with the client to learn the reasons for not following the diet
- D. Make a referral to Meals-on-Wheels
Correct Answer: C
Rationale: Discuss diet with the client to learn the reasons for not following the diet. When new problems are identified, it is important for the nurse to collect accurate assessment data. Before reporting findings to the provider, it is best to have a complete understanding of the client's behavior and feelings as a basis for future teaching and intervention.
A health care agency has different receptacles for the various categories of institutional waste. Into which container should the nurse dispose of a suction canister used to collect bloody drainage from the client's NG tube?
- A. Injurious waste receptacle
- B. Hazardous waste receptacle
- C. Infectious waste receptacle
- D. Wastebasket in the client's bathroom
Correct Answer: C
Rationale: Blood and body fluids are classified as infectious waste, requiring disposal in the infectious waste receptacle.
How is the information documented on incident reports used?
- A. to analyze risk categories
- B. to make sure procedures are in compliance with regulations
- C. to identify the educational needs of the staff
- D. all of the above
Correct Answer: D
Rationale: Risk management utilizes information from incident reports to perform all of the tasks identified.
All of the following clients are in need of an emergency assessment except:
- A. a bleeding client who has an injury from falling debris.
- B. an unresponsive client.
- C. a client with an old injury.
- D. a pregnant woman with imminent delivery.
Correct Answer: C
Rationale: The client with an old injury does not need an emergency assessment because this is not a life-threatening or new situation or condition.