Nokea
You're filling in as a substitute school nurse. When an 11-year-old child with an earache and sore throat reports to the nurse's office, you inspect the tympanic membrane using an otoscope.
Which color suggests a normal eardrum?
- A. Red
- B. White
- C. Gray
- D. Yellowish
Correct Answer: C
Rationale: A normal eardrum appears pearly gray.
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A nurse is administering metoprolol (Lopressor) to a patient with hypertension. Which of the following assessments is most important before administering this medication?
- A. Blood pressure
- B. Respiratory rate
- C. Temperature
- D. Oxygen saturation
Correct Answer: A
Rationale: Metoprolol, a beta-blocker, lowers blood pressure and heart rate, so assessing blood pressure prevents hypotension or bradycardia. Respiratory rate, temperature, and oxygen saturation are less critical.
A client is being admitted with a diagnosis of possible pancreatitis. Which of the following is the best support for this diagnosis?
- A. Pain is in the left upper quadrant of the abdomen
- B. Client reports steatorrhea for the last 3 days
- C. A serum amylase level of 366 U/L
- D. Assessed diminished bowel sounds
Correct Answer: C
Rationale: The client's amylase level is elevated above the normal level of 200 U/L. This measurement is the most accurate indicator of pancreatitis and the most objective and specific. The answers in A, B, and D are also clinical manifestations of pancreatitis, but are not as specific as the laboratory value, so they are incorrect choices.
When explaining the therapeutic regimen of vitamin B12 for pernicious anemia to a patient the nurse should explain that:
When explaining the therapeutic regimen of vitamin B12 for pernicious anemia to a patient the nurse should explain that:
- A. Weekly Z-track injections are required for control.
- B. Daily intramuscular injections are required for control.
- C. Intramuscular injections once a month will maintain control.
- D. Oral tablets of vitamin B12 taken daily will keep the symptoms under control.
Correct Answer: C
Rationale: Monthly B12 injections maintain control in pernicious anemia due to absorption deficits.
The nurse is caring for a client with tuberculosis. Which precautions should the nurse take when providing care for this client? Select all that apply:
- A. Wear gloves when handling tissues containing sputum
- B. Wear a face mask at all times
- C. Keep the client in strict isolation
- D. When the client leaves the room for tests, have all people in contact with him wear a mask
- E. Keep the client's door open to allow fresh air into room and prevent social isolation
- F. Wash hands after direct contact with the client or contaminated articles
Correct Answer: A,B,F
Rationale: The nurse should always wear gloves when handling items contaminated with sputum or body secretions. All staff and visitors must wear face masks when coming in contact with the client in his room; masks must be discarded before leaving the client's room. Hand washing is required after direct contact with the client or contaminated articles. Strict isolation isn't required if the client adheres to special respiratory precautions. The client, not the people in contact with him, must wear a mask when leaving the room for tests. The client should be in a negative-pressure, private room, and the door should remain closed at all times to prevent the spread of infection.
A patient with a history of myocardial infarction is prescribed aspirin. Which of the following instructions should the nurse include?
- A. Take this medication on an empty stomach.
- B. Avoid taking this medication with other NSAIDs
- C. Discontinue the medication if you experience ringing in your ears.
- D. Take this medication only when you have chest pain.
Correct Answer: B
Rationale: Avoiding other NSAIDs prevents increased bleeding risk with aspirin, a key antiplatelet post-MI. Empty stomach increases GI upset, ringing requires reporting, and aspirin is daily, not PRN.