Nokea
Which type of accidental poisoning would the nurse expect to occur in children under age 6?
- A. Oral ingestion
- B. Topical contact
- C. Inhalation
- D. Eye splashes
Correct Answer: A
Rationale: Oral ingestion. Young children are most likely to ingest toxic substances due to their exploratory behavior.
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The parent of a child treated for injuries consistent with suspected child abuse has been told that a report will be made to Child Protective Services (CPS). The parent says angrily to the nurse, 'I don’t know why this is being reported. I told the health care provider (HCP) that it was an accident.' What is the best response by the nurse?
- A. A case worker from CPS will be visiting you in a few days. The case worker can explain it to you then
- B. Did you ask the HCP why it is being reported?
- C. Reporting your child’s injuries is required by law. It is for your child’s safety and protection
- D. Your explanation of your child’s injuries does not seem plausible
Correct Answer: C
Rationale: Explaining that reporting is legally mandated for child safety is factual and nonjudgmental. Deferring to CPS, questioning the parent, or doubting their explanation may escalate tension or avoid responsibility.
The nurse is reinforcing teaching with a client who has a prescription for sertraline for the treatment of depression. Which of the following statements by the client would indicate a correct understanding of the teaching?
- A. I can discontinue the medication as soon as I start feeling better
- B. I should avoid eating aged cheeses, cured meats, or pickled foods
- C. I should expect to feel better within 2 to 3 days after starting this medication
- D. I will report any thoughts of self-harm to my health care provider
Correct Answer: D
Rationale: Reporting self-harm thoughts is critical, as sertraline may increase suicide risk initially. Discontinuing abruptly risks relapse, food restrictions apply to MAOIs, and benefits take weeks, not days.
The nurse is assessing a client who had a thyroidectomy 12 hours ago and is reporting anxiety, tingling around the mouth, and muscle twitching in the hand. Which of the following actions would be a priority for the nurse to take?
- A. Check the area around the incision site for edema
- B. Review the client’s most recent arterial blood gas results
- C. Evaluate the client’s vocal quality and strength
- D. Obtain a blood specimen to check the serum calcium level
Correct Answer: D
Rationale: Anxiety, tingling, and twitching suggest hypocalcemia from parathyroid damage during thyroidectomy, requiring urgent calcium level assessment. Edema, blood gases, and vocal quality are less urgent.
The clinic nurse evaluates a client’s response to levothyroxine after 8 weeks of treatment. What therapeutic responses to the medication should the nurse expect? Select all that apply.
- A. Apical heart rate of 88/min
- B. Elevation of mood
- C. Improved energy levels
- D. Skin is cool and dry
- E. Slight weight gain
Correct Answer: A,B,C
Rationale: Levothyroxine corrects hypothyroidism, normalizing heart rate (88/min), improving mood, and increasing energy. Skin should be warm/moist, and weight loss is expected, not gain.
Laboratory results
Glucose (fasting)
70–110 mg/dL
(3.9–6.1 mmol/L) 126 mg/dL
(7.0 mmol/L)
The nurse in the outpatient clinic is caring for a 40-year-old client with acromegaly. Which of the following findings would be most important to report to the health care provider?
- A. Dark, leathery skin
- B. Fasting blood glucose level
- C. Presence of S3 and S4 heart sounds
- D. Reports of knee pain when walking
Correct Answer: C
Rationale: S3 and S4 heart sounds indicate heart failure, a serious complication of acromegaly due to cardiac hypertrophy, requiring urgent reporting. Skin changes, glucose levels, and knee pain are expected but less critical.