Missed Hurst Questions

homonymous hemianopsia

The loss of the right or left half of the field of vision in both eyes.

Car accidents without rear facing seats

What is the #1 cause of deaths in infants?

Initiate IV of NS 100 ml with Regular insulin 100 units at 10 mL/hr Start a second IV for fluid resuscitation. Insert indwelling urinary catheter

An unresponsive 13 year old is brought into the emergency department. Based on the nursing assessment and current lab data, which interventions would be appropriate for the nurse to initiate?

Assist the client into a supine position in bed. The most frequent cause of headache following a lumbar puncture is loss of, or leaking, of cerebrospinal fluid from the puncture site. Positioning a client is an important nursing responsibility, particularly in this situation since the supine position could help to stop any leaking. Following this, the nurse will pursue additional actions as ordered by the primary healthcare provider, which may include increasing fluids or even a blood patch.

Following a lumbar puncture, the client reports a headache on a pain scale of 8 out of 10. What priority action should the nurse perform?

Check home environment for potential hazards. Safety is always a priority concern, particularly in the client's home environment. This diabetic client already has a foot wound, and anything which might cause further damage or another injury should be addressed by the homecare nurse.

The homecare nurse is visiting a newly diagnosed diabetic being treated for a small left foot wound. What is the nurse's priority assessment on this first home visit?

"Creamed based canned soups are a source of hidden wheat." "You can eat foods containing fax, corn, or rice." "Avoid foods and beverages that contain malt." "Do not eat traditional wheat products such as pasta." Soups and sauces are one of the biggest sources of hidden gluten, as many companies use wheat as a thickener. It is always a good idea to read the label of any pre-prepared or canned soups and sauces, paying special attention to those that are cream based. Grains that are naturally gluten free include rice, corn, potato, quinoa, kasha, flax, and nut flours. Malt flavoring or extract, which contains gluten may be found in cornflakes and puffed rice cereal. It is also found in beers, ales, and malt vinegars. As a rule, traditional wheat products such as pastas, breads, crackers, and other baked goods are not gluten-free. However, there are many gluten-free options available that use alternative flours and grains.

What dietary information should the nurse provide to a client diagnosed with Celiac disease?

RACE. Remove, activate, contain, extinguish

What do you do when there is a fire?

Initiate droplet precaution. Administer erythromycin 10 mg/kg/dose 4 times daily for 7 days. Use client dedicated and disposable equipment. Pertussis is a very contagious disease that spreads from person to person by coughing or sneezing or when spending a lot of time near one another where you share breathing space. The nurse should place the child on droplet precautions in addition to standard precautions. For infants older than 1 month of age, macrolides drugs such as erythromycin are the drugs of choice. With droplet precautions you should use client dedicated or disposable equipment to prevent the spread of infection. If this is not possible, you must clean and disinfect shared/reusable equipment between use. This includes IV pumps, cell phones, pagers, other electronics, supplies, equipment. Clean prior to removing from the room. Bacterial infection

A 9 month old client is admitted to the hospital with a diagnosis of pertussis. Which interventions should the nurse initiate?

Bronchial breath sounds over left lower lobe Upper abdominal discomfort Tachypnea Use of accessory muscles with breathing Signs of pneumonia include bronchial breath sounds over the affected area, fever, tachypnea, tachycardia, crackles, egophony and dullness to percussion. Nasal flaring, use of accessory muscles, and cyanosis may occur as well. Symptoms include malaise, chills, rigor, fever, cough, dyspnea, and chest pain. Pneumonia may manifest as upper abdominal pain when lower lobe infection irritates the diaphragm.

A client has been admitted with a diagnosis of community-acquired pneumonia to the left lower lung lobe. What assessment findings by the nurse would validate this diagnosis?

Administer furosemide. Weigh daily. Measure urine output every 30 - 60 minutes. Diuretics are administered to promote postoperative diuresis. Daily weights are done to make sure there is not rapid weight gain which is a pertinent of fluid retention. Careful and frequent assessment of UOP helps determine fluid balance and transplant function. Oliguria is an early sign of acute tubular necrosis and should be detected as soon as possible post-op.

A client with renal failure has returned to the unit post kidney transplant. Which postoperative interventions should the nurse provide?

HIV+ client with an induration of 6 millimeters. Client who immigrated from Haiti 6 months ago who has an induration of 10 millimeters. 3 year old client with an induration of 12 millimeters. HIV infected clients are considered to have a (+) TB skin test with an induration of 5 millimeters or more. An induration of 10 millimeters or more is considered positive in recent immigrants (less than five years) from high-prevalence countries such as Haiti, and in children less than 4 years of age.

A home health nurse is interpreting Mantoux skin test results of clients who received the test 48 hours ago. Which clients have a positive tuberculin skin test reaction?

Elevate foot of bed to decrease swelling

Immediately following a below-the-knee amputation (BKA), the nurse positions the client to prevent complications. What intervention related to position of the residual limb is a priority at this time?

Furosemide 20.0 mg p.o. daily Folic acid 1 mg daily Heparin 1000 IU subcutaneously daily It is inappropriate to have a trailing zero after a decimal point for doses expressed in whole numbers. It can be mistaken as 200 if the decimal point is not seen. The folic acid order lacks a route, thus needs clarification. The Heparin order should be written as Heparin 1,000 units subcutaneously daily. Use commas for dosing units at or above 1,000 or use words such as one thousand to improve readability. Use units rather than IU (International units) as this can be mistaken as IV or 10.

The nurse is caring for a client admitted with heart failure. Which prescriptions would necessitate that the nurse seek clarification from the primary healthcare provider?

Sit semi-recumbent for meals. Eat small, frequent meals daily. Reduce intake of carbohydrates. The symptoms described indicate the client is experiencing dumping syndrome, an adverse response following gastric or bariatric surgery. Clients may also experience tachycardia, nausea or cramping with the intake of food due to surgical restructuring of the gastrointestinal tract. Because this will be a lifetime issue, the nurse must teach the client to adjust eating habits and patterns. Reduction of carbohydrates will help decrease the problem since carbohydrates speed through the digestive track too quickly. Eating smaller, more frequent meals in a semi-recumbent position will further slow food through the digestive tract and eliminate most of the uncomfortable symptoms. Sitting up after a meal is counterproductive, since this will increase the speed of food through the digestive tract. Therefore, clients are encouraged to lie down on the left side following meals to slow the progress of food through the GI tract.

The nurse is caring for a client following gastric bypass surgery. The client reports dizziness, sweating and palpitations after eating meals. The nurse would recommend which actions to alleviate these symptoms?

Decreases workload of the heart

The parents of a child admitted with rheumatic fever (RF) ask why the child has been placed on bedrest. The nurse explains that bedrest serves what primary purpose for the client?

Hyponatremia Hyperglycemia can cause dilutional hyponatremia, so Normal Saline is administered to replace both fluid and sodium lost through increased urinary output. Serum potassium levels are usually normal when the client arrives with HHS. The potassium will drop as the large volume of NS is administered with IV insulin. Then we worry about hypokalemia.

What electrolyte imbalance should the nurse monitor for in a client diagnosed with hyperosmolar hyperglycemic state (HHS)?

Perform neurovascular checks every 2 hours. Maintain hip flexion at 90 degrees with buttocks raised 1 inch (2.54 cm) off the bed.

What interventions would be appropriate for the nurse to make for a child who is in Bryant's traction?

Direct contact Indirect contact Airborne

What should the nurse include about transmission of the chickenpox virus while teaching a group of parents about the importance of vaccination?

Use of rhyming words when talking

Which type of comment should the nurse expect from a client exhibiting clang associations?