Nokea
While explaining an illness to a 10 year-old, what should the nurse keep in mind about the cognitive development at this age?
- A. They are able to make simple association of ideas
- B. They are able to think logically in organizing facts
- C. Interpretation of events originate from their own perspective
- D. Conclusions are based on previous experiences
Correct Answer: B
Rationale: They are able to think logically in organizing facts. The child in the concrete operations stage is capable of mature thought when organizing objects.
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The nurse is caring for a client with chronic kidney disease who is receiving epoetin alfa (Epogen). Which of the following laboratory results should the nurse report immediately?
- A. Hemoglobin 14 g/dL.
- B. Potassium 4.5 mEq/L.
- C. Creatinine 3.0 mg/dL.
- D. Calcium 9.0 mg/dL.
Correct Answer: A
Rationale: A hemoglobin of 14 g/dL is too high, risking hypertension or thrombosis with epoetin alfa. Options B, C, and D are expected or normal.
The nurse is caring for a 17-year-old married male scheduled for a hernia repair. The nurse administers meperidine hydrochloride (Demerol) 50 mg and hydroxyzine pamoate (Vistaril) 25 mg IM. Thirty minutes later the nurse discovers that the informed consent is unsigned.
Which of the following actions by the nurse is BEST?
- A. Cancel the surgery.
- B. Ask the client to sign the informed consent.
- C. Notify the physician.
- D. Ask the client's mother to sign the informed consent.
Correct Answer: C
Rationale: Strategy: All answers are implementations. Determine the outcome of each answer choice. Is it desired? (1) inappropriate action, should inform physician (2) can't sign informed consent if client has been drinking alcohol or has been pre-medicated for surgery (3) correct-physician needs to be informed (4) married minor is considered emancipated; provides own consent for treatment
A client is receiving an intravenous (IV) infusion for pain control. When caring for this client, which one of these actions can the RN safely assign to an unlicensed assistive personnel (UAP)?
- A. Ask the client the degree of relief and document the client's response
- B. Decrease the set rate on the pump by 2 ml/minute
- C. Check the IV site for drainage and loose tape
- D. Assist the client with ambulation and a gown change with supervision
Correct Answer: D
Rationale: When directing the UAP, communicate clearly and specifically what the task is and what should be reported to the nurse. Implementation of routine tasks should be delegated since they do not require independent judgment.
The nurse is caring for a client who is postoperative day 1 after a lumbar laminectomy. Which of the following actions should the nurse prioritize?
- A. Encourage log-rolling when repositioning
- B. Administer pain medication as needed
- C. Keep the head of the bed elevated 45 degrees
- D. Monitor the surgical drain for output
Correct Answer: A
Rationale: Log-rolling maintains spinal alignment, preventing complications post-laminectomy. Options B, C, and D are secondary: pain management is routine, 45-degree elevation is excessive, and drain monitoring is less urgent.
A client with a temperature of 103°F (39.4°C).
Body compensatory mechanisms would include which of the following?
- A. Decreased respiratory rate and bradycardia.
- B. Normal blood pressure and pulse.
- C. Increased respiratory rate and tachycardia.
- D. Diaphoresis with cool, clammy skin.
Correct Answer: C
Rationale: Strategy: Think about each answer choice. (1) respirations and heart rate will increase with fever (2) blood pressure and pulse usually increase with fever (3) correct-hyperthermia increases the oxygen requirements, which results in faster breathing as well as an increase in the pulse rate (4) diaphoresis may occur, but the skin will be warm