Nokea
Which guidelines would hamper staff learning and compliance?
- A. Provide scientific information regarding nosocomial infections.
- B. Clarify information with staff during each session.
- C. Acknowledge resistance of staff to changes in policies.
- D. Utilize diagrams to provide information.
- E. Provide all information needed to the staff on the first session.
- F. Tell the staff that changes were mandated by hospital policy.
- G. Send a memo regarding errors in IV site care procedure.
Correct Answer: E, F, G
Rationale: Providing all information in one session (E) can overwhelm staff, reducing retention. Stating changes are mandated (F) may foster resentment, decreasing compliance. Sending a memo about errors (G) may seem punitive, discouraging engagement. In contrast, scientific information (A), clarification (B), acknowledging resistance (C), and diagrams (D) promote understanding and acceptance.
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The nurse notes hyperventilation in a client with a thermal injury. She recognizes that this may be a reaction to which of the following medications if applied in large amounts?
- A. Neosporin sulfate
- B. Mafenide acetate
- C. Silver sulfadiazine
- D. Povidone-iodine
Correct Answer: B
Rationale: Mafenide acetate can cause metabolic acidosis, leading to compensatory hyperventilation. The other medications listed do not typically cause this reaction.
Which finding is expected in the normal newborn?
- A. Epstein pearls
- B. Moro reflex
- C. Swan neck deformity
- D. Cracked pot sound
Correct Answer: B
Rationale: The Moro reflex, a startle response to sudden movement, is a normal finding in newborns, present until about 3-6 months. Epstein pearls are benign but not universal, and the others are abnormal.
A client is admitted to the emergency department with a loss of consciousness with unknown etiology. The nurse expects to perform which laboratory test to assist in determining etiology?
- A. Total cholesterol
- B. Alkaline phosphatase
- C. Serum glucose
- D. Urinalysis
Correct Answer: C
Rationale: Serum glucose is critical to rule out hypoglycemia or hyperglycemia as causes of unconsciousness. Cholesterol (A), alkaline phosphatase (B), and urinalysis (D) are less urgent.
The nurse is caring for a client with a history of peptic ulcer disease. Which food should the client avoid?
- A. Spicy foods
- B. Apples
- C. Rice
- D. Milk
Correct Answer: A
Rationale: Spicy foods can irritate the gastric mucosa, exacerbating peptic ulcer disease. Apples, rice, and milk (in moderation) are generally safe.
The nurse is caring for clients on a respiratory unit. Upon receiving the following client reports, which client should be seen first?
- A. Client with emphysema expecting discharge
- B. Bronchitis client receiving IV antibiotics
- C. Bronchitis client with edema and neck vein distention
- D. COPD client with abnormal PO2
Correct Answer: C
Rationale: Edema and neck vein distention in a bronchitis client suggest right heart failure or cor pulmonale, requiring immediate assessment. Emphysema discharge (A), antibiotics (B), and abnormal PO2 (D) are less urgent.