COMP

A child has been diagnosed with a small ventricular septal defect (VSD). Which of the following symptoms would the nurse expect to see?

Poor eating, failure to thrive Fast breathing or breathlessness Easy tiring

A nurse conducts a nutrition class at a local public health department for a group of clients who are newly pregnant. During the class, the nurse collects information about each person's nutritional status and assesses the group for nutritional risk factors during pregnancy. Which of the following clients are at risk for nutritional problems during pregnancy? Select all that apply. 1. A 17-year-old primigravid client who works part time 2. A 25-year-old client who weighs 250 pounds at conception 3. A 19-year-old client who admits that she smokes cigarettes and drinks alcohol 4. A 30-year-old client who is unemployed and uses food stamps 5. A 25-year-old client whose prepregnancy hemoglobin level is 13 g/100 rnL 6. A 30-year-old client who drinks four glasses of milk per day

1,2,3,4 1. A 17-year-old primigravid client who works part time 2. A 25-year-old client who weighs 250 pounds at conception 3. A 19-year-old client who admits that she smokes cigarettes and drinks alcohol 4. A 30-year-old client who is unemployed and uses food stamps

The nurse is teaching the client diagnosed with arterial occlusive disease. Which interventions should the nurse include in the teaching? Select all that apply. 1. Wash legs and feet daily in warm water. 2. Apply moisturizing cream to feet. 3. Buy shoes in the morning hours only. 4. Do not wear any type of knee stocking. 5. Wear clean white cotton socks.

1,2,4,5 1. Cold water causes vasoconstriction and hot water may burn the client's feet; therefore, warm (tepid) water should be recommended. 2. Moisturizing prevents drying of the feet. 4. This will further decrease circulation to the legs. 5. Colored socks have dye, and dirty socks may cause foot irritation that may lead to breaks in the skin.

A client is on contact and airborne precautions. In which order should the nurse don personal protective equipment (PPE) before entering the room? 1. Wash hands 2. Put on exam gloves 3. Put on respiratory protection (mask) 4. Put on isolation gown

1,4,3,2

You have just received a change-of-shift report about these clients on the coronary step-down unit. Which one will you assess first? 1. 26-year-old with heart failure caused by congenital mitral stenosis who is scheduled for balloon valvuloplasty later today 2. 45-year-old with constrictive cardiomyopathy who developed acute dyspnea and agitation about 1 hour before the shift change 3. 56-year-old who underwent coronary angioplasty and stent placement yesterday and has reported occasional chest pain since the procedure 4. 77-year-old who was transferred from the intensive care unit 2 days ago after coronary artery bypass grafting and has a temperature of 100.6° F (38.1° C)

2. 45-year-old with constrictive cardiomyopathy who developed acute dyspnea and agitation about 1 hour before the shift change The client's symptoms indicate acute hypoxia, so immediate further assessments (such as assessment of oxygen saturation, neurologic status, and breath sounds) are indicated. The other clients also should be assessed soon, because they are likely to require nursing actions such as medication administration and teaching, but they are not as acutely ill as the dyspneic client. Focus: Prioritization

During a group session, the members of the group are discussing the types of stressors that affect their lives. Which individual is experiencing a psychological stressor in his or her life? 1. A 32- year old person who was exposed to extreme cold while skiing. 2. A 52-year old who has just learned that her job is being eliminated. 3. A 68-year old person who has a history of hypertension now controlled. 4. A 47-year old person who has a family history of lung and bone cancer.

2. A 52-year old who has just learned that her job is being eliminated. Impending unemployment is a major cause of psychological stress. One loses job security and is unable to cater for their bills. This leads to anxiety due to financial constraints.

A mother calls the clinic to report that her preschool-age child has had a fever, has been fussy, and now has a rash that started on the neck and has spread to the rest of the child's body. The child was exposed to chickenpox about 3 weeks ago. Which advice is the most important to give the mother? 1. Bring the child in immediately so the diagnosis can be confirmed. 2. Treat the child's symptoms and use diphenhydramine (Benadryl) for itching. 3. Be sure the child stays quiet, and limit the amount of television viewing. 4. After the fever is gone, the child can return to day care.

2. Treat the child's symptoms and use diphenhydramine (Benadryl) for itching. RATIONALES: The most likely explanation for the child's illness is chickenpox. The nurse should review the treatment for chickenpox, which includes acetaminophen for fever and fussiness, and oatmeal baths and diphenhydramine for itching. Unless the child is severely ill or has complications, the child doesn't need to be seen in the clinic. Limiting a preschooler's television viewing is appropriate but isn't the most important advice. Typically, children will limit their own activities as needed. The child may still be contagious after the fever subsides. He shouldn't return to day care until after the lesions crust over.

Phentolamine mesylate (Regitine) is administered for the treatment of hypertension associated with pheochromocytoma. Because of its vasodilatory effect, it is also administered via the subcutaneous route to treat:

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A nurse is demonstrating colostomy care to a client with a new colostomy. Which actions would the nurse teach the client to perform? (Select all that apply.)

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When planning the care of an infant suspected of having a tracheoesophageal fistula (tef), it is critical for the nurse to A. hold the infant in a upright position after feeding. 2. feed the infant by enternal feedings 3. feed the infant slowly 4. hold all feedings

4. Hold all feedings Tracheo esphageal fistula TEF, is a congenital anomaly in which the infant is born with a defect/communication between the trachea and the esophagus These infants require special care before surgical correction is executed They should be nursed in a head elevated position to prevent reflux of gastric contents into the trachea and lungs. Enteral feeding should be stopped altogether to prevent aspiration pneumonitis. Parenteral feeding should be used Great emphasis should be put on nutrition and hydration to prevent malnutrition

A 10-year-old is being evaluated for possible appendicitis and complains of nausea and sharp abdominal pain in the right lower quadrant. An abdominal ultrasound is scheduled, and a blood count has been obtained. The child vomits, finds the pain relieved, and calls the nurse. Which should be the nurse's next action? 1. Cancel the ultrasound, and obtain an order for oral Zofran (ondansetron). 2. Cancel the ultrasound, and prepare to administer an intravenous bolus. 3. Prepare for the probable discharge of the patient. 4. Immediately notify the physician of the child's status.

4. Immediately notify the physician of the child's status. The physician should be notified immediately, as a sudden change or loss of pain often indicates a perforated appendix.

A diabetic client who is pregnant asks about breastfeeding. The most accurate response regarding breastfeeding by diabetic mothers is that it is 1. Contraindicated because insulin is passed to the infant through the milk 2. Not contraindicated, but the diabetic's milk production and mechanism may be faulty. 3. Contraindicated because it puts too much stress on the mother's body. 4. Not contraindicated, but encourage.

4. Not contraindicated, but encourage. A diabetic mother can continue to breastfeed her baby. Whether she has type 1, 2 or gestational diabetes, she can and should continue to breastfeed. Diabetic mothers are advised to breastfeed their babies exclusively for 6 months or longer Anti diabetic drugs such as insulin and metformin are safe with breastfeeding. However breastfeeding diabetic mothers should be taught properly about their dietary needs so as to prevent hypoglycemia since breastfeeding is a high calorie requirement state.

During the interview, the client informs the nurse, "I have a son and twin daughters, no abortions, or stillbirths." 17. According to the TPAL method, which of the following accurately records the client's obstetric history? 1. T-III, P-0, A-0, L-III 2. T-III, P-III, A-0, L-0 3. T-III, P-II, A-0, L-II 4. T-II, P-0, A-0, L-III

4. T-II, P-0, A-0, L-III

The following test is used to identify measure allergen-specific antibodies such as IgE

A radioallergosorbent (RAST) test is a blood test using radioimmunoassay test to detect specific IgE antibodies, to determine the substances a subject is allergic to. This is different from a skin allergy test, which determines allergy by the reaction of a person's skin to different substances. Wikipedia

A female client with which condition would be at increased risk for vulvovaginal candidiasis? Select all that apply. A. Uncontrolled diabetes. B. Immunosuppression due to cancer. C. Human immunodeficiency virus (HIV) infection D. Hypertension E. Asthma

A,B,C A. Uncontrolled diabetes. B. Immunosuppression due to cancer. C. Human immunodeficiency virus (HIV) infection RATIONALE: Candidiasis is classified by the Centers for Disease Control and Prevention as complicated or uncomplicated. Women with underlying medical conditions, such as uncontrolled diabetes and HIV infection or cancer-causing immunosuppression, correlate with an increasing severity of candidiasis. Hypertension and asthma are not related to immunosuppression or complicated candidiasis.

The nurse is perfroming woundcare for a client with necrotic sacral wound. The prescibed treatment is isotonic saline solution with fine mesh gauze and a dry dressing to cover. What type of debridement is the nurse performing? A. Surgical debridement B. Nonselective debridement C. Enzymatic debridement D. Selective debridement

B. Nonselective debridement

The nurse is explaining Systemic Inflammatory Response Syndrome (SIRS) to the client's significant other. Which statement best describes SIRS? A. SIRS is a response by the body to sustain a major burn or crushing injury in a motor-vehicle accident. B. SIRS is a response by the body to some type of injury or insult; the insult can be infectious or noninfectious in nature. C. SIRS only occurs when the body is overwhelmed with an infectious organism such as streptococcus bacteria. D. SIRS occurs when the body is allergic to the prescribed antibiotic and the body tries to recover from the allergic response.

B. SIRS is a response by the body to some type of injury or insult; the insult can be infectious or noninfectious in nature. The definition of SIRS.

Which situation exemplifies the ethical principle of beneficence? A. A nurse uses verbal strategies instead of forced seclusion, to calm an agitated client. B.A nurse talks with a client's physician to gain permission for the client to attend an upcoming fieldtrip. C. A nurse encourages a client diagnosed with dementia to choose what to wear for the day. D. A nurse teaches a client about the chronic nature of his or her diagnosis of schizophrenia.

B.A nurse talks with a client's physician to gain permission for the client to attend an upcoming fieldtrip.

A nurse tells a client that the most effective treatment for a rash from lupus erythematosus is A. Getting sun exposure 15 minutes each day. B. Washing with soap and water C. Taking an atimalarial drug D. Getting a varicella vaccine booster.

C. Taking an atimalarial drug Systemic lupus erythematosus is an autoimmune disease affecting almost all the systems in the body. The cutaneous form presents as a rash i.e malar or discoid rash The great majority of cases, even with severe skin involvement, can be controlled with a combination of effective protection against UV light, the use of topical corticosteroids and anti-malarial treatments. Antimalarial drugs are usually very effective, as they help to reduce inflammation and the severity of the rash. Hydroxychloroquine is often well tolerated and usually does not cause any major side effects

The charge nurse is making assignments on a pediatric unit. Which client should be assigned to the licensed practical nurse (LPN)? A. The 6-year-old client diagnosed with sickle cell crisis. B. The 8-year-old client diagnosed with biliary atresia. C. The 10-year-old client diagnosed with anaphylaxis. D. The 11-year-old client diagnosed with pneumonia.

D. The 11-year-old client diagnosed with pneumonia. The LPN can administer routine medication and care for clients who have NO life-threatening conditions.

You are caring for a patient with acute compartment syndrome sustained post motor vehicle accident. Which is not one of the 5 P's of compartment syndrome? A. Pain B. Palor C. Pulsness D. Paralysis E. Paresthesia F.None of the above

F. None of the above All of them are the 5 Ps. pain, pallor (pale skin tone), paresthesia (numbness feeling), pulselessness (faint pulse) and paralysis (weakness with movements

The nurse understand that the therapeutic effect of cerumenolytics (hydrogen peroxide solution) is ?

The medical term for earwax is cerumen, and hydrogen peroxide is a cerumenolytic, which means that it can soften, break down, and dissolve earwax. Ear drops can contain a variety of forms of hydrogen peroxide

A client with advanced laryngeal tumor is to have radiation therapy . The patient tells the nurse "if I am going to have radiation, I won't need surgery." What is the best response by the nurse? a) "All patients have to have radiation before they have surgery. It is protocol." b) "Radiation is used to shrink the tumor size and is an adjunct to surgery." c) "That is correct. The radiation will eradicate the tumor and you won't have to have further treatment." d) "You really don't have to have radiation but you won't have to have such invasive surgery if you have the radiation first."

b. "Radiation is used to shrink the tumor size and is an adjunct to surgery." Explanation: Radiation therapy may also be used preoperatively to reduce the tumor size. Radiation therapy is combined with surgery in advanced laryngeal cancer as adjunctive therapy to surgery or chemotherapy and as a palliative measure.

Which of the following usually is the first indication of Duchenne's muscular dystrophy?

frequent falls, trouble getting up or running, waddling gait, big calves, and learning disabilities.