Nokea
Which nurse should be assigned to care for the postpartal client with preeclampsia?
- A. The nurse with 2 weeks of experience on the postpartum unit
- B. The nurse with 3 years of experience in labor and delivery
- C. The nurse with 10 years of experience in surgery
- D. The nurse with 1 year of experience in the neonatal intensive care unit
Correct Answer: B
Rationale: The nurse with 3 years of experience in labor and delivery (answer B) should be assigned to care for the postpartal client with preeclampsia. This nurse has the most relevant experience and knowledge of possible complications associated with preeclampsia due to their background in labor and delivery. Assigning a nurse with only 2 weeks of experience on the postpartum unit (answer A) would not be suitable for handling the complexities of caring for a client with preeclampsia. Nurses with experience in surgery (answer C) or the neonatal intensive care unit (answer D) lack the specific expertise needed for managing a postpartal client with preeclampsia, making them unsuitable choices for this assignment.
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When teaching clients with a diagnosis of Schizophrenia nearing discharge from a residential care facility, what is an essential topic to include?
- A. pathophysiology of the disease and expected symptoms.
- B. how to recognize and manage symptoms of relapse.
- C. the need to take extra medication when feeling stressed.
- D. the importance of contact with follow-up care daily.
Correct Answer: B
Rationale: When educating clients with Schizophrenia nearing discharge, it is crucial to focus on teaching them how to recognize and manage symptoms of relapse. Clients are usually aware of these symptoms, such as feeling anxious and overwhelmed, before the onset of psychosis. This early stage is vital for intervention, which involves finding a safe environment, seeking help, avoiding stressors, and reducing stimuli. Understanding and managing relapse symptoms empower clients to take proactive steps in their care. Choices A and C are not as immediate and practical as recognizing symptoms of relapse for client safety and well-being. While contact with follow-up care is important, it is not as urgent and specific as knowing how to manage relapse symptoms for immediate intervention.
The client is visiting a home health client with osteoporosis. The client has a new prescription for alendronate (Fosamax). Which instruction should be given to the client?
- A. Rest in bed after taking the medication for at least 30 minutes
- B. Avoid rapid movements after taking the medication
- C. Take the medication with water only
- D. Allow at least 1 hour between taking the medicine and taking other medications
Correct Answer: B
Rationale: When a client is prescribed alendronate (Fosamax), instructing them to avoid rapid movements after taking the medication is crucial to prevent esophageal irritation. Resting in bed after taking the medication for at least 30 minutes (choice A) is not necessary and can increase the risk of side effects. While taking the medication with water only (choice C) is generally recommended, the key instruction to prevent esophageal irritation is to avoid rapid movements. Allowing at least 1 hour between taking the medicine and other medications (choice D) is not specifically related to the administration of alendronate and is not the primary concern when giving instructions to the client.
During a school screening, a nurse notices small bruises on the anterior and posterior ribs of an 8-year-old Asian child. The nurse should ask the child:
- A. if the family practices coining
- B. who performs coinings
- C. if the child has fallen
- D. how long the child has been abused
Correct Answer: A
Rationale: The correct answer is to ask if the family practices coining. In Asian cultures, coining is a traditional practice believed to draw infections from the body. It involves rubbing a heated coin on the chest and torso, which can cause bruising similar to what the nurse noticed on the child's ribs. This question is important to differentiate between cultural practices and potential child abuse. Choices B, C, and D are incorrect because assuming abuse without considering cultural practices can lead to misinterpretation and inappropriate actions. It's crucial for healthcare providers to be culturally sensitive and gather all relevant information before making conclusions.
Several clients are admitted to the emergency room following a three-car vehicle accident. Which clients can be assigned to share a room in the emergency department during the disaster?
- A. The schizophrenic client experiencing visual and auditory hallucinations and the client with ulcerative colitis
- B. The client who is 6 months pregnant with abdominal pain and the client with facial lacerations and a broken arm
- C. A child with fixed and dilated pupils and his parents, and the client with a frontal head injury
- D. The client who arrives with a large puncture wound to the abdomen and the client with chest pain
Correct Answer: B
Rationale: The correct answer is to assign the client who is 6 months pregnant with abdominal pain and the client with facial lacerations and a broken arm to share a room. The pregnant client needs close monitoring due to the abdominal pain, and the client with facial lacerations and a broken arm requires immediate attention for wound care and possible fracture management. Choice A should not be assigned together as the schizophrenic client experiencing visual and auditory hallucinations needs a separate room for privacy and safety, and the client with ulcerative colitis may require isolation due to the risk of infection. Choice C is incorrect because the child with fixed and dilated pupils is likely in a critical condition and should be in a private room with parents, while the client with a frontal head injury needs a separate room for focused care. Choice D is also incorrect as the client with a large puncture wound to the abdomen needs immediate attention in a separate room, and the client with chest pain requires evaluation and monitoring in a separate setting as well.
The women's health charge nurse is making assignments for the next shift. The unit is short one staff member and will receive a nurse from the medical-surgical unit. Which group of clients should she assign to the medical-surgical nurse?
- A. Total abdominal hysterectomy, bladder suspension with A&P repair, client with breast reduction
- B. C-section planning discharge, post-partum infection, mastectomy
- C. Vaginal delivery of fetal demise, C-section with pneumonia, 32-week gestation with lymphoma
- D. 28-week gestation of bed rest, post-partum with HELLP syndrome, breast reconstruction
Correct Answer: A
Rationale: The correct answer includes clients who have undergone surgical procedures typically managed on a medical-surgical unit. Choice A consists of clients who have had elective surgical procedures such as hysterectomy, bladder suspension with A&P repair, and breast reduction, which are commonly treated in a medical-surgical setting. Choices B, C, and D involve clients with various complications related to childbirth, fetal demise, pneumonia, gestational lymphoma, HELLP syndrome, and bed rest, which are more complex cases requiring specialized care beyond medical-surgical nursing.