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Which finding by the nurse suggests that the mother is not giving the toddler iron supplements as ordered?
- A. The child has pale skin.
- B. There is light brown stool in the diaper.
- C. The child takes a nap every day.
- D. The child has ecchymotic areas on her legs.
Correct Answer: B
Rationale: Iron supplements typically cause dark or black stools; light brown stools suggest non-compliance with iron supplementation.
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A client has chronic obstructive pulmonary disease exacerbation. The pulse oximeter shows a saturation of 86% on room air. The nurse finds bilateral diminished lung sounds and low-pitched wheezing posteriorly, shallow respirations, respiratory rate of 32/min, and use of accessory muscles. What is the most appropriate oxygen delivery device for this client?
- A. Nasal cannula
- B. Non-rebreathing mask
- C. Oxymizer
- D. Venturi mask
Correct Answer: D
Rationale: A Venturi mask (D) delivers precise oxygen concentrations, ideal for COPD exacerbation to avoid hypercapnia. Nasal cannula (A), non-rebreathing mask (B), and Oxymizer (C) are less precise.
The nurse in a long-term care facility is caring for a client with major depressive disorder who is reporting difficulty sleeping. The client gets up during the night, paces the hallway, wrings the hands, and appears teary. Which of the following actions should the nurse take? Select all that apply.
- A. Arrange for the client to receive at least 20 minutes of natural sunlight each day
- B. Encourage the client to take naps during the day
- C. Instruct the client to engage in physical exercise just before bedtime
- D. Provide the client with a cup of warm milk in the evening
- E. Spend time with the client in a quiet environment just before bedtime
- F. Suggest that the client listen to soft music before going to bed
Correct Answer: A, D, E, F
Rationale: Natural sunlight exposure (A) helps regulate circadian rhythms and improve mood. Warm milk (D) contains tryptophan, which promotes sleep. A quiet environment (E) and soft music (F) reduce stimulation and promote relaxation. Naps (B) may disrupt nighttime sleep, and exercise before bedtime (C) can be stimulating.
An adult who has newly diagnosed angina has been prescribed sublingual nitroglycerin. What should be included in the nurse's teaching about the medication? Select all that apply.
- A. Put the tablets under your tongue and let them dissolve.
- B. Keep the tablets in a dark glass container.
- C. You can take one tablet, and if you still have pain, you can take another tablet in 10 minutes.
- D. Be sure to take nitroglycerin while you are standing up.
- E. You may get a headache shortly after you take the medication,
- F. If your tongue tingles spit out the tablet.
Correct Answer: A,B,E
Rationale: Sublingual nitroglycerin is dissolved under the tongue, stored in dark glass to maintain potency, and may cause headaches as a side effect.
A newborn has been diagnosed with hypothyroidism. In discussing the condition and treatment with the family, the nurse should emphasize
- A. They can expect the child will be mentally retarded
- B. Administration of thyroid hormone will prevent problems
- C. This rare problem is always hereditary
- D. Physical growth/development will be delayed
Correct Answer: B
Rationale: Administration of thyroid hormone will prevent problems. Early identification and continued treatment with hormone replacement corrects this condition.
The nurse helps the health care provider perform a thoracentesis at the bedside. In which position does the nurse place the client to facilitate needle insertion and promote comfort?
- A. Fetal position, lying on unaffected side with knees drawn to the abdomen and hands clasped around them
- B. Lying on the affected side with head of the bed elevated to 30-45 degrees
- C. Prone with head turned to the affected side and arms over the head, supported by a pillow
- D. Upright leaning forward over the bedside table, with arms supported on pillows
Correct Answer: D
Rationale: Upright leaning forward (D) facilitates lung expansion and fluid access while ensuring comfort. Other positions (A, B, C) are less effective or uncomfortable.