Nokea
Which question is asked more than any other root cause analysis activity?
- A. What?
- B. Why?
- C. Who?
- D. When?
Correct Answer: B
Rationale: The 'Why?' question is central to root cause analysis, as it drives the investigation into the underlying causes of an event through techniques like the '5 Whys.'
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The nurse developing a plan of care for a postterm small-for-gestational-age (SGA) newborn should identify which assessment as the priority to monitor?
- A. Urinary output
- B. Blood glucose levels
- C. Total bilirubin levels
- D. Hemoglobin and hematocrit
Correct Answer: B
Rationale: The most common metabolic complication in the SGA newborn is hypoglycemia, which can produce central nervous system abnormalities and mental retardation if not corrected immediately. Urinary output, although important, is not the highest priority action; however, the postterm SGA newborn is typically dehydrated from placental dysfunction. Hemoglobin and hematocrit levels are monitored because the postterm SGA newborn exhibits polycythemia, although this also does not require immediate attention. The polycythemia contributes to increased bilirubin levels, usually beginning on the second day after delivery.
When determining the parents' compliance with treatment for their child's ear infection, the nurse should ask the parents if they are:
- A. Cleaning the child's ear canals with hydrogen peroxide.
- B. Administering continuous, low-dose antibiotic therapy.
- C. Instilling ear drops regularly to prevent cerumen accumulation.
- D. Holding the child upright when feeding with a bottle.
Correct Answer: D
Rationale: Holding the child upright during feeding prevents milk from entering the Eustachian tube, reducing ear infection risk.
A client with a history of chronic heart failure is prescribed digoxin (Lanoxin). The nurse should monitor the client for which of the following signs of toxicity? Select all that apply.
- A. Nausea.
- B. Visual disturbances.
- C. Tachycardia.
- D. Fatigue.
- E. Hypokalemia.
Correct Answer: A, B, D
Rationale: Digoxin toxicity presents with nausea, visual disturbances (e.g., yellow vision), and fatigue. Hypokalemia increases toxicity risk but is not a symptom.
A client has just been admitted with acute delirium of unknown etiology. The client's daughter states that she is worried about her mom because she has never acted this way before. The nurse's best response is:
- A. I understand your concern. Let's discuss what specific changes you've noticed.'
- B. Delirium is common in older adults and usually resolves quickly.'
- C. We'll run some tests to find out what's causing this behavior.'
- D. Don't worry, we'll take good care of her.'
Correct Answer: A
Rationale: Discussing specific changes encourages the daughter to provide details, aiding in identifying the delirium's cause and tailoring care.
A client with rheumatoid arthritis reports morning stiffness. Which intervention should the nurse recommend?
- A. Apply cold packs to joints
- B. Perform vigorous exercise upon waking
- C. Take a warm shower in the morning
- D. Avoid all physical activity
Correct Answer: C
Rationale: A warm shower in the morning increases blood flow and reduces joint stiffness, a common symptom of rheumatoid arthritis.