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Why should the nurse wake up a client who is to undergo an EEG at midnight?
- A. Because excess sleep may make the client lazy and nervous for the EEG
- B. Because optimum sleep helps regulate the breathing patterns during the EEG
- C. Because it helps the client to fall asleep naturally during the EEG
- D. Because it reduces the chances of getting a headache when electrodes are fixed to the scalp of the client
Correct Answer: B
Rationale: The nurse should wake up a client who is to undergo an EEG at midnight to ensure that the client receives optimum sleep before the procedure. Optimum sleep helps regulate the client's breathing patterns during the EEG, resulting in more accurate readings. Adequate rest is essential for brain activity monitoring to be as normal as possible. Waking the client at midnight allows for enough time for the client to fall back asleep before the EEG is conducted, ensuring the best possible conditions for the procedure.
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An adolescent teen has bulimia. Which assessment finding should the nurse expect to assess?
- A. Diarrhea
- B. Amenorrhea
- C. Cold intolerance
- D. Erosion of tooth enamel
Correct Answer: D
Rationale: Bulimia involves recurrent episodes of binge eating followed by compensatory behaviors such as vomiting. The frequent exposure of the teeth to stomach acid during vomiting can lead to erosion of tooth enamel. This can result in dental issues such as decay, sensitivity, and discoloration. Therefore, erosion of tooth enamel is a common assessment finding in individuals with bulimia. The other options (A. Diarrhea, B. Amenorrhea, C. Cold intolerance) are not typically associated with bulimia.
Mrs. Adams is scheduled for an intravemous pyelogram (IVP). Nurse Aura wpould be most concerned if the patient makes which of the following comments or statements?
- A. "I take Senokot (laxative) daily."
- B. "I often feel like my bladder is full even after voiding."
- C. "My whole face turns red when I eat mussels."
- D. "I experience headaches every 2 weeks."
Correct Answer: A
Rationale: Nurse Aura would be most concerned about the patient's statement regarding taking Senokot daily because laxatives can affect kidney function and urine production, which are important considerations during an intravenous pyelogram (IVP). Laxatives can lead to dehydration and electrolyte imbalances, which may affect the results and safety of the IVP procedure. It is crucial for the patient to disclose any medications or substances they are taking that could impact kidney function or urine production prior to undergoing the IVP. The other statements are not directly related to the IVP procedure or potential complications.
When teaching umbilical cord care to a new mother, the nurse would include which information?
- A. Apply peroxide to the cord with each diaper change
- B. Cover the cord with petroleum jelly after bathing
- C. Keep the cord dry and open to air
- D. Wash the cord with soap and water each day during a tub bath
Correct Answer: C
Rationale: Keeping the cord dry and open to air is the recommended practice for umbilical cord care. This helps the cord to dry out and fall off naturally. Applying substances like peroxide or petroleum jelly can create a moist environment, which can increase the risk of infection. Washing the cord with soap and water daily can also prolong the time it takes for the cord to fall off. Thus, the best approach is to simply keep the cord clean and dry, allowing it to heal and detach on its own.
Which of the following intravenous solutions is hypotonic?
- A. Normal saline
- B. Ringer's lactate
- C. 0.45% saline
- D. 5% dextrose in normal saline  A1 PASSERS TRAINING, RESEARCH, REVIEW & DEVELOPMENT COMPANY MEDICAL SURGICAL NURSING SET F
Correct Answer: C
Rationale: A hypotonic solution has a lower concentration of solutes compared to the cells in the body. 0.45% saline is hypotonic because it has a lower concentration of sodium chloride compared to the normal extracellular fluid in the body. When this solution is administered intravenously, water will move into the cells to balance the concentration gradient, potentially causing cellular swelling. A hypotonic solution is used to rehydrate cells in cases of hypernatremia or dehydration with cellular dehydration.
When assessing the external ear, the nurse palpates a small protrusion of the helix called a Darwin tubercle. The nurse would document this finding as which of the following?
- A. A normal finding
- B. An abnormal finding
- C. A normal finding only in the older adult
- D. An abnormal finding only in the older adult
Correct Answer: A
Rationale: A Darwin tubercle is a small, painless, hereditary nodule located on the helix of the ear. It is a normal anatomical variation and is present in varying degrees in the general population, regardless of age. Therefore, it would be documented as a normal finding during the assessment of the external ear.