Safety and Infection Control EAQ
Which is essential for ensuring disaster readiness in a community? A. Trauma system B. State government C. Federal government D. Emergency response system
A
What is a manifestation of tertiary syphilis? A. Chancre B. Alopecia C. Gummas D. Condylomata lata
C
What causes condylomata acuminate? A. Chlamydia B. Gonorrhea C. Herpes simplex D. Human papillomavirus (HPV)
D
What is the most effective strategy for preventing the transmission of infection? A. Wearing gloves and a gown B. Applying face mask and a gown C. Applying a face mask and gloves D. Wearing gloves and hand hygiene
D
A nurse is caring for a school-aged child with AIDS. Which action is the nurse's priority of care? A. Maintaining optimal hydration B. Protecting the child from infection C. Promoting growth and development D. Ensuring adequate and balanced nutrition
B
For which illness should airborne precautions be implemented? A. Influenza B. Chickenpox C. Pneumonia D. Respiratory syncytial virus
B
A child becomes cyanotic during a generalized tonic-clonic seizure. What is the most appropriate action by the nurse? A. Inserting an oral airway B. Administering oxygen by mask C. Continuing to observe the seizure D. Notifying the practitioner immediately
C
A home health nurse teaches a father how to provide oral care for his 8-year-old child who is undergoing chemotherapy. The nurse observes a return demonstration and determines that he needs further teaching when he tries to use which dental hygiene product? A. A cotton swab B. Mild toothpaste C. Saline mouthwash D. An electric toothbrush
D
A child undergoes tonsillectomy and adenoidectomy for numerous recurrent respiratory tract infections. After the surgery, what should the nurse teach the parents to do? A. Offer crushed ice chips. B. Encourage the intake of ice cream. C. Keep the child in the supine position. D. Gargle with a diluted mouthwash solution.
A
A nurse is planning to provide discharge teaching to the family of a client with acquired immunodeficiency syndrome (AIDS). Which statement should the nurse include in the teaching plan? A. "Wash used dishes in hot, soapy water." B. "Let dishes soak in hot water for 24 hours before washing." C. "You should boil the client's dishes for 30 minutes after use." D. "Have the client eat from paper plates so they can be discarded."
A
What should be used to clean needles and syringes between intravenous drug users (IDUs)? A. Bleach B. Hot water C. Ammonia D. Rubbing alcohol
A
What sexually transmitted diseases are caused by bacteria? Select all that apply. A. Syphilis B. Hepatitis C. Gonorrhea D. Herpes simplex E. Trichomoniasis
A, C
A client with an abdominal wound infected with methicillin-resistant Staphylococcus aureus (MRSA) is scheduled for a computed tomography (CT) scan of the abdomen. To ensure client and visitor safety during transport, the nurse should implement which precaution? A. No special precautions are required. B. Cover the infected site with a dressing. C. Drape the client with a covering labeled biohazardous. D. Place a surgical mask on the client.
B
What is the most commonly reported sexually transmitted infection (STI)? A. Syphilis B. Chlamydia C. Gonorrhea D. Herpes simplex
B
An infant is admitted to the neonatal intensive care unit with exstrophy of the bladder. What covering should the nurse use to protect the exposed area? A. Loose diaper B. Dry gauze dressing C. Moist sterile dressing D. Petroleum jelly gauze pad
C
What determines if a client will develop AIDS from an HIV infection? A. Level of IgM in the blood B. The number of CD4+ T-cells available C. Presence of antigen-antibody complexes D. Speed with which the virus invades the RNA
B
Which are examples of internal disasters that must be accounted for when formulating a disaster response plan? Select all that apply. A. Fire B. Hurricane C. Earthquake D. Power outage E. Act of terrorism
A, D
A 10-year-old child in whom autism was diagnosed at the age of 3 years attends a school for developmentally disabled children and lives with parents. The child has frequent episodes of self-biting and head-banging and needs help with feeding and toileting. What is the priority nursing goal for this child? A. Controlling repetitive behaviors B. Being able to feed independently C. Remaining safe from self-inflicted injury D. Developing control of urinary elimination
C
A client is informed that he has developed a healthcare-associated upper respiratory tract infection and asks the nurse what this means. How should the nurse reply? A. "You developed an infection that requires antibiotics." B. "This is a highly contagious infection requiring isolation." C. "You acquired the infection after being admitted to the hospital." D. "An infection you had before beginning treatment has flared up."
C
A client, experiencing an exacerbation of Crohn disease, is admitted to the hospital for intravenous steroid therapy. The nurse should not assign this client to a room with a roommate who has which illness? A. Pancreatitis B. Thrombophlebitis C. Bacterial meningitis D. Acute cholecystitis
C
The nurse determines that a young female client who is being treated for a sexually transmitted infection (STI) understands instructions regarding future sexual contacts. Which client statement confirms the nurse's conclusion? A. "If I have sex, nothing I do will really prevent me from getting another STI." B. "If I get another STI, I can take any antibiotic, because I'm not allergic to any of them." C. "I won't have unprotected sex again, and I'll tell my partners to be tested for STIs." D. "I have to ask my partners if they have an STI, and if they say no I'll know that I can have sex."
C
Which is the first antibody formed after exposure to an antigen? A. IgA B. IgE C. IgG D. IgM
D
A 2-year-old toddler requires close supervision to protect against potential accidents. The nurse teaches a class for parents about the learning style of toddlers. How do toddlers learn self-protection? A. Through trial-and-error strategies B. By imitating playmates and siblings C. By obeying orders from mother and father D. By playing with age-appropriate toys and puzzles
A
A nurse is caring for a client with scabies. Which information about scabies should the nurse consider when planning care for this client? A. Highly contagious B. Caused by a fungus C. Chronic with exacerbations D. Associated with other allergies
A
A nurse is caring for a young, hyperactive child with attention deficit-hyperactivity disorder who engages in self-destructive behavior. What is the most important nursing objective in the planning of care for this child? A. Keeping the child from inflicting any self-injury B. Helping the child improve communication skills C. Helping the child formulate realistic ego boundaries D. Providing the child with opportunities to discharge energy
A
A nurse is preparing a 5-year-old girl who has undergone a myringotomy for discharge. What should the parents be taught about their child's care at home? A. Insert earplugs whenever a bath is given. B. Keep cotton in the ears until drainage subsides. C. Keep the child out of kindergarten until the ears are healed. D. Clean the child's ears with cotton-tipped swabs after each bath.
A
A nurse is counseling the family of a child with AIDS. What is the most important concern that the nurse should discuss with the parents? A. Risk for injury B. Susceptibility to infection C. Inadequate nutritional intake D. Altered growth and development
B
The nurse is preparing to initiate intravenous antibiotic therapy for a client who developed an infection along the incision after having a total knee replacement. Before starting the first dose of intravenous antibiotics, which task should the nurse ensure has been completed? A. Red blood cell count B. Wound culture C. Knee x-ray D. Urinalysis
B
A 10-year-old child with recently diagnosed asthma is receiving information about the use of a peak expiratory flow meter (PEFM). The nurse knows that the child understands how to use the PEFM when she makes which statement? A. "I have to blow out as fast and hard into the machine as I can." B. "I can stand or sit to use the flow meter. I just can't lie down." C. "I have to take three readings and record the average on the flow sheet." D. "I'll use the meter whenever I can throughout the day—it doesn't really matter when."
A
A child with meningitis suddenly assumes an opisthotonic position. In what position should the nurse position the child? A. Side-lying B. Knee-chest C. High-Fowler D. Trendelenburg
A
The nurse is assessing four clients who were injured in a mass casualty event. Which client does the nurse plan to treat first according to the disaster triage tag system? A. Client belonging to class I B. Client belonging to class II C. Client belonging to class III D. Client belonging to class IV
A
The nurse is providing instruction to a parent of a child with influenza. Which statement by the parent indicates the need for further instruction? A. "I'll manage the fever with baby aspirin." B. "We'll make sure to get a flu shot next season." C. "Providing fluids will help relieve the symptoms." D. "Staying home from school will prevent transmission."
A
When caring for a client who is receiving enteral feedings, the nurse should take which measure to prevent aspiration? A. Elevate the head of the bed between 30 and 45 degrees. B. Decrease flow rate at night. C. Check for residual daily. D. Irrigate regularly with warm tap water.
A
Which noninvasive assessment and management skills certification would the nurse be required to use for airway maintenance and cardiopulmonary resuscitation (CPR)? A. Basic Life Support (BLS) B. Certified Emergency Nurse (CEN) C. Advanced Cardiac Life Support (ACLS) D. Pediatric Advanced Life Support (PALS)
A
Which of these age groups has the highest incidence of lead poisoning? A. Adult B. Toddler C. Adolescent D. School-age child
B
A 15-month-old child is hospitalized after ingesting toilet bowl cleaner. The mother confides that she feels guilty about leaving the cleaner where her child could get it. What is the best response by the nurse? A. "Anyone could make a mistake. Don't dwell on it." B. "Let's not worry about the past. Your child is going to get better." C. "It was an accident, but you should consider special locks on your closets." D. "That was careless of you. Please make sure that you poison-proof your house."
C
A 4-year-old child is brought to the pediatric clinic for a well-child visit. While entering the examination room the child bumps into the door jamb and then tilts his head to one side. The nurse suspects that the child has strabismus. What additional clinical finding supports this conclusion? A. Bloodshot sclera B. Excessive blinking C. Frequent squinting D. Continuous tearing
C
A client has Clostridium difficile. The nurse is providing discharge instructions related to decreasing the risk of transmission to family members. What would be appropriate to include in the client's teaching? A. Increase fluids. B. Increase fiber in the diet. C. Wash hands with soap and water. D. Wash hands with an alcohol-based hand sanitizer.
C
A nurse is caring for a 13-year-old child who has an external fixation device on the leg. What is the nurse's priority goal when providing pin care? A. Easing pain B. Minimizing scarring C. Preventing infection D. Preventing skin breakdown
C
A nurse provides discharge teaching to a client who had a total hip replacement. The client states that the plan is to go swimming at the community pool the day after discharge. How should the nurse respond? A. Instruct the client to take a friend along for safety. B. Encourage participation in this activity, because it provides excellent range-of-motion exercise. C. Explain that the incision should not be immersed in water until it has healed. D. Let the client know that swimming can substitute for the prescribed physical therapy.
C
A parent and 3-month-old infant are visiting the well-baby clinic for a routine examination. What instruction should the nurse include in the accident-prevention teaching plan? A. Remove small objects from the floor. B. Cover electric outlets with safety plugs. C. Test the temperature of water before bathing. D. Remove toxic substances from accessible areas.
C
A preschool child is found to have atopic dermatitis. The nurse emphasizes that the child should be discouraged from scratching. The child's mother asks why scratching should be prevented. What is the nurse's response? A. "Scratching causes lesions to become more contagious." B. "Scratching spreads dermatitis to other areas of the body." C. "Scratching results in skin breaks that can lead to infection." D. "Scratching produces changes that are precursors to skin cancer."
C
An 8-year-old girl who is hospitalized for intravenous antibiotic therapy tells the nurse that she is bored. The nurse has a discussion with the father about appropriate activities. Which activity suggested by the father indicates a need for further teaching? A. "I'll bring a radio and CD player." B. "I'll bring homework and school supplies." C. "She'll enjoy having a rubber baseball and plastic bat." D. "She'll enjoy rubber stamps and a pretty box to keep them in."
C
The nurse finds a green triage tag on a client. What does the nurse infer from this finding? A. The client belongs to class I. B. The client belongs to class II. C. The client belongs to class III. D. The client belongs to class IV.
C
Which hospital department plays a primary role in disaster preparedness? A. Medical department B. Surgical department C. Emergency department D. Mental health department
C
A nurse counsels the mother of an 8-month-old infant to be sure that the floors are free of small objects when her child is crawling. What is the rationale for this instruction? A. Sharp objects can injure the fragile skin of an infant. B. Eight-month-old infants hide small objects, making them difficult to locate. C. Floors may cause infections in infants when they pick up and mouth objects. D. Eight-month-old infants pick up small objects and place them in their mouths.
D
Which toddler-age client has reached a height in which it is no longer safe to sleep in a crib? A. 26 inches B. 28 inches C. 33 inches D. 36 inches
D
A nurse is caring for a client admitted to a mental health unit because of suicidal ideation. Which intervention provides the greatest safety for this client? A. Seclusion room B. Four-point restraints C. Constant one-on-one supervision D. Removal of unsafe objects from the environment
C
A nurse is teaching a client about human immunodeficiency virus (HIV). What are the various ways HIV is transmitted? Select all that apply. A. Mosquito bites B. Sharing syringe needles C. Breastfeeding a newborn D. Dry kissing the infected partner E. Anal intercourse
B, C, E
A nurse is preparing to change a client's dressing. Which information should the nurse recall for using surgical asepsis? A. Keep the area free of microorganisms. B. Protect self from microorganisms in the wound. C. Confine the microorganisms to the surgical incision site. D. Limit the number of opportunistic microorganisms to a minimum.
A
While visiting the hospital, the spouse of a client slips and falls on a recently washed floor in the hallway leading to the client's room. To meet the criteria of ethical practice, what action should the nurse who witnessed the occurrence take? A. Initiate an agency incident report. B. Report the fall to the state (provincial) health department. C. Write a brief description of the incident to be kept by the nurse manager. D. Determine that no documentation is needed because the visitor is not a client in the hospital.
A
A nurse who is admitting a newborn to the nursery observes a fetal scalp monitor site on the scalp. Which complication should the nurse monitor this newborn for? A. Injury B. Infection C. Feeding problems D. Respiratory distress
B
A burn client is receiving the open method for wound treatment. Which information will the nurse explain to the client? A. Bathing will not be permitted. B. Dressings will be changed daily. C. Personal protective equipment will be worn by staff. D. Room temperature will be kept below 72° F (22.2° C).
C
Which generation of nursing professionals, being exposed to both terrorism and natural disasters, should be key members for disaster planning initiatives? A. Veteran B. Generation X C. Generation Y D. Baby Boomer
C
A client expresses concern that because of supply and demand there is no vaccine available for the annual flu vaccine. What is the nurse's best reply? A. "It's unfortunate, but there was such a limited supply available." B. "There are many others who also were unable to get a flu vaccine." C. "It doesn't matter because the vaccine is for just one particular strain." D. "There are other things you can do to prevent the flu, such as hand washing."
D
A child is being treated with oral ampicillin for otitis media. What should be included in the discharge instructions that the nurse provides to the parents of the client? A. Complete the entire course of antibiotic therapy. B. Herbal fever remedies are highly discouraged. C. Administer the medication with meals. D. Stop the antibiotic therapy when the child no longer has a fever.
A
A client with a leg prosthesis and a history of syncopal episodes is being admitted to the hospital. When formulating the plan of care for this client, the nurse should include that the client is at risk for what? A. Falls B. Impaired cognition C. Imbalanced nutrition D. Impaired gas exchange
A
A client with localized redness and swelling due to a bee sting reports intense local pain, a burning sensation, and itching. What would be the most appropriate nursing action? A. Applying cold compresses to the affected area B. Ensuring the client keeps the skin clean and dry C. Monitoring for neurological and cardiac symptoms D. Advising the client to launder all clothes with bleach
A
A nurse is caring for a client with acquired immunodeficiency syndrome (AIDS). What precautions should the nurse take when caring for this client? A. Use standard precautions. B. Employ airborne precautions. C. Plan interventions to limit direct contact. D. Discourage long visits from family members.
A
A nurse is working with a child who was physically abused by a parent. What is the most important goal for this family? A. The child will live in a safe environment. B. The parents will use verbal discipline effectively. C. The family will feel comfortable in its relationship with the counselor. D. The parents will gain an understanding of their abusive behavior patterns.
A
A parent receives a note from school reporting that a student in class has head lice. The parent calls the school nurse to ask how to check for head lice. What instruction should the nurse provide? A. "Ask the child where it itches." B. "Check to see whether your dog has ear mites." C. "Look at your child's head along the scalp line for white dots." D. "Inspect your child's hands and look between the fingers for red lines."
A
A school-aged child is to receive a blood transfusion. What should the nurse do first if an allergic reaction to the blood occurs? A. Shut off the infusion. B. Slow the rate of flow. C. Administer an antihistamine. D. Call the healthcare provider.
A
A young child with acute nonlymphoid leukemia is admitted to the pediatric unit with a fever and neutropenia. What are the most appropriate nursing interventions to minimize the complications associated with neutropenia? A. Placing the child in a private room, restricting ill visitors, and using strict hand washing techniques B. Encouraging a well-balanced diet, including iron-rich foods, and helping the child avoid overexertion C. Avoiding rectal temperatures, limiting injections, and applying direct pressure for 5 minutes after venipuncture D. Offering a moist, bland, soft diet; using toothettes rather than a toothbrush; and providing frequent saline mouthwashes
A
The nurse manager is reviewing the hospital disaster plan with other members of the committee. Which is the minimum number of disaster drills the committee must plan and implement each year? A. Two B. Three C. Four D. Five
A
The primary objective of nursing intervention for clients with dementia, delirium, and other cognitive disorders is to maintain what? A. Safety within the environment B. Psychological faculties C. Participation in educational activities D. Face-to-face contact with other clients
A
What is an example of a type I hypersensitivity reaction? A. Anaphylaxis B. Serum sickness C. Contact dermatitis D. Blood transfusion reaction
A
What is the priority when the nurse is establishing a therapeutic environment for a client? A. Ensuring the client's safety B. Accepting the client's individuality C. Promoting the client's independence D. Explaining to the client what is being done
A
Which would the nurse state is an example of a natural disaster? A. Floods B. Terrorism C. Fire explosion D. Building collapse
A
Which threats, included in the term "NBC", lead to the implementation of improved emergency medical services (EMS) and hospital safety programs? Select all that apply. A. Nuclear B. Biologic C. Botulism D. Chemical E. Nipha virus
A, B, D
A child with a diagnosis of tuberculosis is admitted to the pediatric unit. Which location should the nurse select as the best placement for the child? A. Private room B. Isolation room C. Four-bed room D. Semiprivate room
B
A client diagnosed with osteomyelitis is being discharged. Which statement indicates a need for further teaching? A. "I will take the antibiotic at the same time every day." B. "I will take the antibiotic regularly until my symptoms subside." C. "I will take the antibiotic with food if I develop gastric distress when on the antibiotic." D. "I will notify my healthcare provider and stop taking the medication if I develop a rash or shortness of breath."
B
A client who complains of memory loss, nervousness, insomnia, and fear of leaving the house is admitted to the hospital after several days of increasing incapacitation. What nursing action is the priority in light of this client's history? A. Evaluating the client's adjustment to the unit B. Providing the client with a sense of security and safety C. Exploring the client's memory loss and fear of going out D. Assessing the client's perception of reasons for the hospitalization
B
A client who develops heart failure has a serum potassium level of 2.3 mEq/L (2.3 mmol/L). Digoxin and potassium chloride are prescribed. What action should the nurse take? A. Double the dose of potassium chloride and administer it with the prescribed digoxin. B. Hold the dose of digoxin, administer the potassium chloride, and call the primary healthcare provider immediately. C. Give the digoxin and potassium chloride as prescribed and report the laboratory results to the primary healthcare provider. D. Administer the prescribed digoxin and potassium chloride with a glass of orange juice and continue to monitor the client.
B
A mother with the diagnosis of acquired immunodeficiency syndrome (AIDS) states that she has been caring for her baby even though she has not been feeling well. What important information should the nurse determine? A. If she has kissed the baby B. If the baby is breast-feeding C. When the baby last received antibiotics D. How long she has been caring for the baby
B
A nurse explains to the parents of a 6-year-old child with a pinworm infestation how pinworms are transmitted. What statement indicates that the teaching has been understood? A. "We need to keep the cat off the bed." B. "She needs to wash her hands before eating anything." C. "She needs to cover her mouth whenever she coughs." D. "We need to tell the school so that the cafeteria can be cleaned."
B
A nurse in the emergency department is caring for a 9-year-old child with a suspected spinal cord injury sustained while falling off a bicycle. What is the initial nursing action? A. Placing the child's head on a pillow for support B. Immobilizing the child's spine to limit additional injury C. Log-rolling the child to check for lacerations on the back D. Moving the child onto a firm stretcher for transport to the radiography department
B
A nurse is teaching a parent how to prevent accidents while caring for a 6-month-old infant. What ability should be emphasized with regard to the infant's motor development? A. Sits up B. Rolls over C. Crawls short distances D. Stands while holding on to furniture
B
A school nurse is planning to teach the importance of hand washing to the children in first grade. What is the most effective approach for this age group? A. Showing a video of the correct hand washing technique B. Demonstrating hand washing and asking for return demonstrations C. Involving them in a discussion about the importance of hand washing D. Describing how germs cause illness and how hand washing prevents disease
B
A school nurse is teaching a group of parents about pediculosis capitis (head lice). What common secondary infection does the nurse teach the parents to identify? A. Eczema B. Impetigo C. Cellulitis D. Folliculitis
B
At the age of 3 weeks an infant undergoes surgery to repair a cleft lip. What should postoperative nursing care include? A. Using a spoon to administer oral feedings B. Cleansing the suture line to prevent infection C. Offering a pacifier for sucking to prevent crying D. Using wrist restraints to keep the infant's hands away from the face
B
The parent of a 2-year-old calls a nurse who is a neighbor and reports that the child just ate several multivitamins with iron. What should the nurse say to the parent? A. "Give your child orange juice." B. "Call the Poison Control Center." C. "Iron-fortified multivitamins are safe for your child." D. "Administer an emetic—syrup of ipecac, if you have it."
B
What is the priority when a nurse is formulating a plan of care for a client with a diagnosis of dementia of the Alzheimer type? A. Implementing remotivational therapy B. Structuring the environment for safety C. Arranging for long-term custodial care D. Stimulating thinking with new experiences
B
Which nursing action should be included in the plan of care for a child with acute poststreptococcal glomerulonephritis? A. Encouraging fluids B. Monitoring for seizures C. Measuring abdominal girth D. Checking for pupillary reactions
B
Which stage of HIV would a client with a CD4+ T-cell count of 325 cells/mm 3 be classified? A. Stage 1 B. Stage 2 C. Stage 3 D. Stage 4
B
Which team member acts as a liaison between the health care facility and the media? A. Triage officer B. Public information officer C. Medical command physician D. Hospital incident commander
B
Which term describes the practice of placing clients with the same infection in a semi-private room? A. Isolating B. Cohorting C. Colonizing D. Cross-referencing
B
While walking to the examination room with the nurse, a toddler with autism suddenly runs to the wall and starts banging the head on it. What should the nurse's initial action be? A. Allowing the toddler to act out feelings B. Asking the toddler to stop this behavior C. Restraining the toddler to prevent head injury D. Telling the toddler that the behavior is unacceptable
C
A postpartum nurse is reviewing principles related to automobile infant restraint systems with the parents of a newborn who is to be discharged in the morning. What information should be included in the teaching session? Select all that apply. A. Use a forward-facing infant car seat. B. Secure the infant seat so that it faces the rear. C. Position the seat between the driver's and passenger's seats in the front seat. D. Follow the manufacturer's directions to secure the infant seat in the back seat. E. Be sure to follow weight guidelines set forth in the manufacturer's instructions.
B, D, E
A nurse is planning to teach the four-point alternate crutch gait to a 9-year-old child with cerebral palsy. How does the nurse explain this choice to the parents? A. The child has minimal step ability in the lower extremities. B. It provides for two points of support on the floor at all times. C. It provides for equal but partial weight bearing on each limb. D. The child has more power in the upper extremities than in the lower extremities.
C
What criteria should the nurse consider when determining if an infection should be categorized as a health care-associated infection? A. Originated primarily from an exogenous source B. Is associated with a drug-resistant microorganism C. Occurred in conjunction with treatment for an illness D. Still has the infection despite completing the prescribed therapy
C
What is it imperative for a mental health nurse to prevent clients from doing? A. Breaking contracts B. Using delusional thinking C. Harming themselves or others D. Engaging further in hallucinatory thoughts or behaviors
C
What should the nurse encourage the parents of a child with plumbism (lead poisoning) to do? A. Discourage the child's pica by providing nutritious snacks. B. Move the family away from areas that are next to gas stations. C. Assess the family's home environment for lead sources and have them removed. D. Have the child take repeat x-rays of the wrist and forearm for signs of a lead line.
C
Which action would the nurse think should be excluded to prevent staff from having posttraumatic stress disorder (PTSD) during a mass casualty assessment? A. To work less than 12 hours B. Encourage and motivate team members C. To work continuously without any breaks D. To discuss feelings with the team members
C
Which method of delivering client care works well in disaster situations? A. Team nursing B. Primary nursing C. Functional nursing D. Total patient care nursing
C
Which pregnancy safety category shows a proven risk of fetal harm, but potential benefits of use during pregnancy may be acceptable despite its risks? A. Category A B. Category C C. Category D D. Category X
C
A client has been diagnosed with type 1 diabetes mellitus. When providing instructions on sharps disposal, the nurse should instruct the client to place the syringes in what? A. Bubble wrap/packaging wrap B. A garbage bag in the trash can C. A cardboard box with a firmly secured lid D. A plastic liquid detergent bottle with a screw-top lid
D
A client is admitted to the hospital for a total hip replacement. Included in the primary healthcare provider's prescriptions is a prescription for digoxin 2.5 mg by mouth daily. The nurse knows that digoxin is supplied in 0.125 mg tablets. What should the nurse do? A. Give half a tablet. B. Administer two tablets. C. Ask the client what dose was taken at home. D. Verify the prescription with the primary healthcare provider.
D
A client whose spouse died 2 years ago is brought to the psychiatric unit by a family member, who states that the widowed spouse has no interests, is neglecting personal hygiene, and has become totally isolated. The nurse completes a history and physical examination that verifies the family member's concerns. What is most important for the nurse to explore with the client at this time? A. Feelings about the spouse's death B. The real cause of the depressed behavior C. The relationship with the deceased spouse D. Whether suicide has been considered recently
D
A nurse is caring for an older adult with a history of recent memory loss. Which action should the nurse take? A. Instruct the client to move slowly when changing positions B. Remind the client to look where places feet while walking C. Adjust the daily schedule to accommodate sleep pattern D. Employ electronic devices that provide alerts
D
A psychologist has been a client on a mental health unit for 3 days. The client has questioned the authority of the treatment team, advised other clients that their treatment plans are wrong, and been disruptive in group therapy. What is the most appropriate nursing intervention? A. Telling the other clients to disregard what the client is saying B. Ignoring the client's disruptive behavior and waiting for it to subside C. Restricting the client's contact with other clients until the disruptive behavior ceases D. Accepting that the client is unable to control this behavior and setting appropriate limits
D
A school nurse is asked to develop a program for teachers about infection control, especially focusing on hand washing technique. What is the most effective way for the nurse to evaluate what the teachers have learned? A. Observe the teachers lecture the children about hand hygiene. B. Give an objective written final examination to the teachers. C. Schedule a seminar for the teachers to share their knowledge. D. Watch the teachers demonstrate infection control techniques.
D
A school nurse is teaching a health class of 12-year-olds about hepatitis C. Which statement by a student indicates an understanding of the origin of the disease? A. "You can catch it while you're getting a tattoo." B. "You're more likely to get it in crowded living conditions." C. "The disease is passed from person to person by casual contact." D. "People working at restaurants can give it to you if they don't wash their hands."
D
After a cleft lip repair a nurse places elbow restraints on the infant. The parents ask the nurse, "Why does our child have to have restraints?" How should the nurse respond? A. "They're used routinely on infants who have had lip surgery." B. "Legally we're required to put them on infants after lip surgery." C. "The staff can't be with your baby continuously to prevent touching of the mouth." D. "Because we're keeping the arms straight, your baby won't be able to touch the mouth."
D
An adolescent girl with a seizure disorder refuses to wear a medical alert bracelet. What should the nurse tell the girl that may help her wear the bracelet consistently? A. Hide the bracelet under long-sleeved clothes. B. Wear the bracelet when engaging in contact sports. C. Ask her friends to wear bracelets that look like hers. D. Select a bracelet similar to bracelets worn by her peers.
D
An older adult with a diagnosis of delirium on the mental health unit begins acting out while in the dayroom. What is the initial nursing intervention? A. Instructing the client to be quiet B. Allowing the client to act out until fatigue sets in C. Guiding the client from the room by gently holding the client's arm D. Giving the client one simple direction at a time in a firm, low-pitched voice
D
Two nurses are planning to help a client with one-sided weakness move up in bed. What should the nurses do to conform to a basic principle of body mechanics? A. Instruct the client to position one arm on each shoulder of the nurses. B. Direct the client to extend the legs and remain still during the procedure. C. Have both nurses shift their weight from the front leg to the back leg as they move the client up in bed. D. Position the nurses on either side of the bed with their feet apart, gather the pull sheet close to the client, turn toward the head of the bed, and then move the client.
D
What should the nurse teach a client who is taking antihypertensives to do to minimize orthostatic hypotension? A. Wear support hose continuously. B. Lie down for 30 minutes after taking medication. C. Avoid tasks that require high-energy expenditure. D. Sit on the edge of the bed for 5 minutes before standing.
D
Which statement helps the nurse determine that a woman with genital herpes (HSV-2) understands her self-care in regards to this infection? A. "When I have a baby, I don't want a cesarean." B. "I can have sex as soon as the herpes sores have healed." C. "When I finish the acyclovir prescription I will be cured." D. "I must be careful when I have sex because herpes is a lifelong problem."
D