Health & Illness MNL

The nurse is providing care to several clients on a​ medical-surgical unit. The nurse needs to prioritize care for the assigned clients. Which action is a common pitfall when prioritizing client​ care? 1. Administering medications based on vital signs at admission 2. Involving the client during the care plan process 3. Completing tasks based on level of difficulty 5. Being cognizant of time when completing tasks

1 A common pitfall when prioritizing care is prioritizing care without completing an assessment. Administering medications based vital signs obtained at admission is failing to assess the​ client, as the​ client's condition may have changed since admission. Involving the client during the care plan​ process, completing tasks based on level of​ difficulty, and being cognizant of time when completing tasks are not pitfalls related to prioritizing care.

A pediatric client with a suspected arm fracture is brought to the emergency department. As the healthcare provider removes the splint applied by​ EMS, the​ client's mother​ exclaims, "Why are you taking that​ off? Doesn't my child need that​ splint?" What is the best response by the​ nurse? 1. ​"A splint is used to stabilize fresh injuries. We have to remove it to see what other treatment your child might​ need." 2. ​"The Velcro straps make it easy for us to take the splint off. We are just adjusting it because EMS had to put it on​ quickly." 3. "We will put the splint right back on after we figure out what other treatments your child might​ need." 4. ​"We are going to put a less supportive cast on your child. If any swelling​ occurs, this will keep the supportive device from getting too​ tight."

1 A splint is an emergency measure used to stabilize fresh injuries and reduce mobility. It is removed to perform diagnostic tests on an injured limb to see if further treatment is necessary. It is not necessarily replaced if a more supportive device like a cast is necessary. Velcro straps do make a splint easy to​ remove, but it is not being removed because EMS applied it incorrectly. A cast is more​ supportive, not less​ supportive, than a splint.

The home care nurse is evaluating the care provided to an​ 18-month-old child recovering at home from bronchiolitis caused by respiratory syncytial virus​ (RSV). Which observation indicates that the parents have provided adequate​ care? 1. The child​'s oxygen saturation is​ 98% on room air 2. The child has moderate nasal flaring with respirations 3. The child becomes drowsy while eating lunch 4. The child has a faint wheeze upon auscultation

1 An outcome that indicates that care provided to the child at home was adequate would be an oxygen saturation level of​ 98% on room air. Drowsiness while eating lunch indicates fatigue while trying to eat and breathe. Audible wheezing indicates the presence of lung congestion. Nasal flaring with respirations indicates breathing difficulty.

A young adult client is recovering from a fractured radius that occurred 7 weeks ago. The​ client's healing is progressing normally. The nurse anticipates that the client is experiencing which process of bone​ healing? 1. Bony callus formation 2. Macrophage invasion of wound 3. Hematoma formation 4. Bone remodeling

1 Bony callus formation occurs after fibrocartilaginous formation and continues for 2dash-3 months after the injury. Fibrocartilaginous callus formation begins within 48 hours and lays the groundwork for bony callus formation. Macrophage wound invasion and hematoma formation occur immediately after the injury and ends within a few days. Bone remodeling is the last stage after bony callus formation.

The nurse provides teaching to the parents of a child with bronchiolitis about care needed at home. Which statement by the parents indicates instructions have been​ effective? 1. ​"It is important to give our child extra​ fluids." 2. ​"We will administer the prescribed amoxicillin 1 hour before​ meals." 3. ​"We will provide extra stimulation for our​ child." 4. ​"We should stop the antibiotics once the bronchiolitis symptoms go​ away."

1 Encouraging fluids will help keep the​ child's secretions thin and easier to remove through coughing or suctioning. Fluids also prevent dehydration. Minimizing external stimulation is an important part of​ at-home care for a child recovering from bronchiolitis. Antibiotics are not given to a child with bronchiolitis because it is caused by a viral infection.

The student nurse is discussing the pathophysiology of Parkinson disease​ (PD) with the nurse. The nurse recognizes that the student understands the development of the disease if the student identifies which event as the first change that occurs in a client with​ PD? 1. Neurons in the cerebrum atrophy and dopamine pathways degenerate. 2. Dopamine levels in brain tissue decreases. 3. Sensory and motor neurons become overexcited. 4. Dopamine is not available in brain tissue to regulate acetylcholine.

1 Parkinson disease​ (PD) is caused by an imbalance between the neurotransmitters dopamine and acetylcholine in the brain.​ Initially, the neurons in the cerebrum atrophy and the dopamine pathways degenerate. This leads to a reduction in the amount of dopamine in the brain. When insufficient amounts of dopamine are​ present, acetylcholine cannot be regulated. This causes over excitation of sensory and motor neurons.

The nurse is caring for a client with a​ nonbleeding, closed femur fracture. The healthcare provider wants to evaluate the client for leakage of blood into the surrounding tissue. The nurse anticipates that which test will be ordered for the​ client? 1. Hematocrit 2. ​X-ray 3. Bone scan 4. White blood cell count

1 Red blood cell indices are used to assess for excessive blood loss and evaluate for anemia. As much as 500 mL of blood can leak into the surrounding tissues as a result of a fractured femur. White blood cell counts would be more useful in determining the presence of infection.​ X-rays and bone scans are more useful for determining bone damage.

A​ 14-month-old child is admitted to the intensive care unit for treatment of severe bronchiolitis caused by respiratory syncytial virus​ (RSV). Which medication does the nurse anticipate will be prescribed for this​ client? 1. Ribavirin 2. Aminophylline 3. Dopamine 4. Atropine

1 Ribavirin is an antiviral medication that may be prescribed for severe cases of bronchiolitis caused by RSV.​ Atropine, dopamine, and aminophylline are not medications identified in the treatment of a client with severe bronchiolitis caused by RSV.

A community health nurse is teaching a group of pregnant clients regarding sudden infant death syndrome​ (SIDS) and the causes associated with the syndrome. Which statement is appropriate for the nurse to include in the teaching​ session? 1. SIDS is thought to be caused by a combination of factors. 2. SIDS is thought to be caused by infant immunizations. 3. SIDS is thought to be caused by respiratory disease. 4. SIDS is thought to be caused by newborn apnea.

1 SIDS is believed to be related to a combination of the following three​ factors: physiologic vulnerabilities​ (abnormalities of the cardiorespiratory control center in the​ brainstem); position while​ sleeping; age​ (within first 6 months of​ life). SIDS has not been linked to respiratory​ disease, newborn​ apnea, or infant immunizations.

A​ client, concerned about a deformity that resulted from an oblique fracture of the​ femur, states,​ "I can't believe one leg is shorter than the other now. I look so​ strange!" The client has no complaints of pain. Physical assessment by the nurse reveals normal findings except for the shortened leg. The nurse understands that the client is at greatest risk for which potential​ problem? 1. Increased risk for body image disruption 2. Potential for neurovascular impairment 3. Diminished tissue perfusion 4. Alterations in skin integrity

1 The client is at greatest risk for body image​ disruption, as the client is clearly upset about the deformity that resulted from the fracture. Physical assessment reveals normal​ findings, so it is less likely that the client has neurovascular​ impairment, skin integrity​ issues, or diminished tissue perfusion.

The parents of a child diagnosed with bronchiolitis ask the nurse how the disorder is treated. Which response by the nurse is the most​ appropriate? 1. ​"The focus is on managing symptoms and providing supportive​ care." 2. ​"Antibiotics will be given for a period of 10​ days." 3. ​"A medication called dexamethasone always produces​ improvement." 4. ​"An inhaler will be used and the symptoms will be gone in about 24​ hours."

1 There is no effective treatment for bronchiolitis. Nurses should become familiar with preventive measures and supportive care. Bronchiolitis is caused by a viral​ infection; antibiotics are not part of the treatment. There has been no demonstrated improvement in signs and symptoms of bronchiolitis with the use of dexamethasone. Inhaled bronchodilators produce little or no improvement in signs and symptoms.

The mother of a​ 2-year-old child with bronchiolitis caused by respiratory syncytial virus​ (RSV) asks why the child has been coughing so much. Which response by the nurse is the most​ appropriate? 1. The virus causes cellular debris that creates large amounts of mucus that stimulate the cough reflex 2. The virus causes body fluids to move into the​ lungs, which the body coughs to try to remove. 3. The bacterial infection irritates the lining of the bronchial tubes and stimulates the cough reflex. 4. The bacterial infection forces white blood cells to move into the lungs which are removed by coughing.

1 With bronchiolitis caused by​ RSV, the virus attacks the epithelial cells of the upper and lower respiratory tract. The destruction of epithelial cells leads to the production of debris and​ mucus, which stimulates coughing. Bronchiolitis caused by RSV does not cause body fluid shifts. RSV is a virus and not a bacterial infection. Coughing with bronchiolitis caused by RSV is not caused by irritation of the bronchial tubes or an attempt to remove white blood cells from the lungs.

After eating tomatoes canned at​ home, a farmer came into the emergency​ department, acutely ill. What is a likely cause of the​ farmer's distress? 1. Response to the enzymes of tomatoes 2. Response to the microbes of botulism 3. Response to the acid of tomatoes 4. Response to the toxins of botulism

4 The​ farmer's distress is due to a response to the toxins of botulism. The​ farmer's response is not due to​ acid, microbes, or enzymes.

The nurse is caring for a client with a cast and notices that the client does not respond to touch in that limb. How would the nurse describe this​ finding? 1. Paralysis 2. Prickliness 3. Pallor 4. Paresthesia

4 ​Paresthesia, due to nerve​ compression, can result in a loss of sensation or a feeling of​ "pins and​ needles." Pallor is a loss of color in the skin. Paralysis is the inability to move a body part or extremity. Prickliness is not an element of the neurovascular assessment.

A nurse is providing care for a client with Parkinson disease. When assessing the​ client's current​ condition, about which items should the nurse​ ask? ​(Select all that​ apply.) 1. Response to medication 2. Cognitive deficits 3. Bowel changes 4. Dizziness when sitting 5. Difficulty waking

1, 2, 3 It is important to ask the client about responses to​ medication, especially any​ "on-off" or​ "wearing off" effects that indicate that medication is losing its effectiveness. The client will also have cognitive deficits such as memory​ loss, slowed​ thinking, and​ confusion, which eventually progress to dementia. The client with Parkinson disease​ (PD) has problems with peristalsis. This contributes to​ constipation, as does poor nutrition caused by tremors and dysphagia. Clients with PD have difficult falling and staying asleep rather than​ too-deep sleep. Postural hypotension is common in Parkinson​ disease, resulting in blood pressure that drops when the client stands​ up, not sits down. Dizziness is a symptom of postural hypotension.

Which health promotion activities would be the focus of teaching for a client with Parkinson​ disease? ​(Select all that​ apply.) 1. Promoting independence 2. Improving balance 3. Participating in occupational therapy 4. Preventing injury from falls 5. Avoiding exercise

1, 2, 3, 4

The nurse is teaching a client with a skin infection about the prescriber​'s choice of medication. What are the rationales for the use of topical​ agents, rather than systemic​ medications? (Select all that​ apply.) 1. Most effective 2. Least toxic 3. Most convenient 4. Least painful 5. Most available

1, 2 For skin​ infections, topical agents are most effective and least toxic. It is not a question of​ availability, convenience, or pain avoidance.

During a home​ visit, the community health nurse becomes concerned that a​ 2-year-old child is at risk for contracting respiratory syncytial virus​ (RSV). Which observations would lead the nurse to this​ conclusion? ​(Select all that​ apply.) 1. Both parents unemployed 2. Both parents smoke cigarettes 3. Absence of soap at the kitchen sink 4. Toddler shares drinking cup with older brother 5. Toddler wearing clean but rumpled pants and shirt

1, 2, 3, 4 Risk factors for the contraction of RSV include living in socioeconomically disadvantaged​ circumstances, exposure to secondhand​ smoke, questionable use of soap to wash​ hands, and sharing drinking utensils. Wearing clean but rumpled clothing is not a risk factor for the contraction of RSV.

What actions support the​ nurse's plan of care for the goal of preventing​ SIDS? (Select all that​ apply.) 1. Collaborating with family to create goals 2. Educating about reducing risk factors for SIDS 3. Promoting a safe sleep environment 4. Encouraging the use of formula 5. Providing support for smoking cessation

1, 2, 3, 5

Which are manifestations of dehydration in a child with​ bronchiolitis? ​(Select all that​ apply.) 1. Delayed capillary refill 2. Weak peripheral pulses 3. Decreased urine output 4, Intercostal muscle retractions 5. Dry sticky mucous membranes

1, 2, 3, 5

A female client fell approximately 10 feet off a ladder while hanging decorations on the outside of the house. As the client was​ landing, she attempted to catch herself with outstretched arms. EMS personnel are transporting the client to the emergency department and suspect a fracture of the right wrist. Which manifestations would the nurse anticipate observing in the​ client? ​(Select all that​ apply.) 1. Pain 2. Crepitus 3. Muscle spasms 4. Brown or yellow discoloration 5. Deformity

1, 2, 3, 5 The manifestations of a fracture include​ deformity, swelling,​ pain, tenderness,​ numbness, guarding,​ crepitus, hypovolemic​ shock, muscle​ spasms, or ecchymosis. A contusion is a swollen and discolored area on the skin. The musculoskeletal injury causes blood to leak into the soft​ tissue, resulting in a purple or blue discoloration or a bruise. When the blood​ reabsorbs, the area becomes brown and yellow until it disappears. The ecchymosis seen with a fracture will start as purple or blue in​ color, not brown or​ yellow, until reabsorption begins.

A nurse on the​ medical-surgical unit is admitting an older adult client to the unit. The nurse is concerned that the client has Parkinson disease when the nurse makes which assessment​ findings? ​(Select all that​ apply.) 1. The client does not remember what he ate for breakfast. 2. The client has hand tremors at rest. 3. The client​'s facial expression shows no emotion. 4. The client​'s blood pressure increases when the client stands up. 5. The client has slurred speech.

1, 2, 3, 5 Tremors at rest are very common in Parkinson disease and easy to identify. Tremors may occur in the​ hands, face,​ neck, lips,​ tongue, and jaw. Parkinson disease causes a​ frozen, mask-like expression​ (lack of​ affect). The client will not have an expression that is consistent with the emotions the client is feeling. Memory loss occurs in Parkinson disease because of the loss of neurons and to other changes in the brain. The client may develop dementia. Parkinson disease causes slowed​ movements, including slurred speech. Postural​ hypotension, not​ hypertension, is a common manifestation in clients with Parkinson disease. This is caused by damage to the autonomic nervous system.

A client sustained an open femoral fracture during a skiing accident. The nurse understands that this client is at risk for infection. What would the nurse need to do since the client is at risk for​ infection? ​(Select all that​ apply.) 1. Assess wound for​ size, color, or presence of drainage 2. Assess temperature every 4 hours 3. Withhold pain medication to assess for manifestations of infection 4. Use aseptic technique with dressing changes 5. Avoid disturbing pins in external fixation device

1, 2, 4 Clients who have open fractures are at risk for infection. The nurse would assess the wound for manifestations of​ infection, assess vital​ signs, use aseptic technique to change​ dressings, provide pin care as​ prescribed, and administer antibiotics as prescribed. Pin care varies by​ facility, but all pins require care to remove crusts and prevent infection. Pin care may include gently cleansing the pin site daily to weekly with a cleansing​ solution, such as sterile saline or chlorhexidine. Withholding pain medication would not be an appropriate intervention for a client with an open fracture. Manifestations of an infection can be assessed in a client receiving pain medication.

The nurse is concerned that a​ 9-month-old child being treated for bronchiolitis caused by respiratory syncytial virus​ (RSV) is developing respiratory distress. Which assessment findings support this​ concern? ​(Select all that​ apply.) 1. Onset of expiratory grunting 2. Visible intercostal retractions with ventilations 3. Femoral pulse weak and 120 beats per minute 4. Respiratory rate increased from 30 to 48 a minute 5. Systolic blood pressure 10 mmHg less than previous measurement

1, 2, 4 Manifestations of the increased work of breathing include​ grunting, retractions, and rapid respiratory rate. A​ weak, thready rapid pulse and low blood pressure are manifestations associated with dehydration.

A nurse is caring for a couple whose infant has died. When planning​ care, what outcomes are most appropriate for the nurse to​ establish? ​(Select all that​ apply.) 1. The couple seeks therapy for psychosocial wellness. 2. The couple acknowledges the grieving process. 3. The couple seeks clarity for the exact cause of death. 4. The couple demonstrates effective coping. 5. The couple demonstrates acceptable grief.

1, 2, 4 Nursing outcomes or goals for the parents of a child who has died as a result of SIDS should focus on the​ parent's psychosocial wellness and demonstration of the​ parents' effective coping. A couple who seeks clarity of the exact cause of death is not necessarily displaying effective coping or psychosocial​ wellness, as the exact cause of the​ SIDS-related death is often not discovered. Acceptable grief is a subjective goal as everyone grieves differently.

The parents of a child undergoing thorough diagnostic tests for an unexplained ongoing fever ask the pediatric​ nurse, "What does this word procalcitonin refer ​to?close double quote" Which details can the nurse give​ them? ​(Select all that​ apply.) 1. Marker of sepsis 2. Precursor of a hormone 3. Metabolite of calcium 4. Mediator in lung and systemic infections 5. Ultrasonic exam material

1, 2, 4 Procalcitonin is the precursor of the hormone​ calcitonin, a marker of​ sepsis, and a mediator in lung and systemic infections. Procalcitonin has nothing to do with calcium or ultrasound exams.

A nurse is caring for a client who is pregnant with her first child. The nurse is providing the client with education about the prevention of SIDS. Which statements made by the nurse are​ correct? ​(Select all that​ apply.) 1. Breastfeed your baby if possible. 2. The temperature in your baby​'s room should be similar to your room. 3. It is best to​ co-sleep with your baby. 4. Place your baby on its back to sleep. 5. Tuck loose blankets under your baby​'s shoulders during sleep.

1, 2, 4 When implementing teaching for the prevention of​ SIDS, the nurse will include the importance of​ breastfeeding, maintaining an appropriate room​ temperature, and placing the infant on the back to sleep.​ Co-sleeping increases the risk of SIDS as does having loose blankets in the crib. These statements are not appropriate by the nurse.

What risk factors put an otherwise healthy infant at risk for the development of​ SIDS? (Select all that​ apply.) 1. Exposure to smoke 2. ​Co-sleeping infants 3. ​High-birth-weight infants 4. Family history of SIDS 5. Male infants

1, 2, 4, 5

The nurse is teaching the parents of a​ 3-year-old child with respiratory syncytial virus​ (RSV) on ways to help the child recover quickly from the disorder. What should the nurse include in this​ teaching? ​(Select all that​ apply.) 1. Help the child to blow the nose to clear the airway 2. Provide frequent small meals throughout the day 3. Limit visits by other friends until the infection clears 4. Wash hands thoroughly after caring for the child 5. Permit the child to rest and nap throughout the day

1, 2, 4, 5 Instructions that the nurse can provide to the parents of a child with RSV to recover quickly include encouraging the child to blow the nose to keep the airway clear. The parents should also provide frequent small meals so that the child does not become fatigued while eating. The child should be permitted to rest and nap as much as possible and the parents should wash their hands thoroughly after caring for the child. RSV is contagious so no children should be permitted to visit while the child is ill.

A client is newly prescribed trihexyphenidyl​ (Artane) for manifestations of Parkinson disease. What manifestations does Artane​ treat? ​(Select all that​ apply.) 1. Tremors 2. Drooling 3. Loss of perspiration 4. Dizziness 5. Rigidity

1, 2, 5 Artane is an anticholinergic medication that causes a decrease in salivation. This medication can cause dry mouth because it is very effective. Artane decreases tremors by blocking acetylcholine. Acetylcholine that is unopposed by dopamine causes the tremors of Parkinson disease. Artane decreases rigidity by blocking acetylcholine.​ Initially, the client may experience an increase in tremors until rigidity is resolved. Artane suppresses perspiration. The client taking this medication will have problems with temperature control because the client will not be able to perspire to cool off. Parkinson disease causes orthostatic​ hypotension, which can cause the client to become dizzy when the blood pressure drops. Artane does not treat orthostatic hypotension. It can cause dizziness as a side effect.

The nurse is reviewing the records of newly admitted clients in a nursing home. The nurse understands that which clients are at greater risk for​ fractures? ​(Select all that​ apply.) 1. The client with osteoporosis 2. The client with Paget disease 3. The client with osteoarthritis 4. The client with leukemia 5. The client with bone neoplasms

1, 2, 5 Bone​ neoplasms, osteoporosis, and Paget disease are associated with pathological fractures. Osteoarthritis and leukemia are not associated with pathological fractures.

A nurse is caring for a couple whose infant has died from sudden infant death syndrome​ (SIDS). Which nursing interventions are appropriate for the nurse to​ implement? (Select all that​ apply.) 1. Calling the parents​' church leader after a request from the parents. 2. Calling the hospital chaplain and requesting his presence immediately. 3. Offering to contact a grief counselor to help the parents 4. Calling the police to begin the death investigation. 5. Offering to contact the parents​' other children to discuss the infant​'s death.

1, 3 The nurse who is implementing appropriate nursing interventions for a grieving​ couple, may offer to contact a grief counselor to help the parents.​ Also, the nurse may call the​ parents' church leader after the request from the parents. Calling the hospital chaplain and requesting his immediate presence is not culturally​ sensitive, as not all grieving clients would like this. The nurse is not responsible for calling the police to begin the death investigation following an​ infant's death from SIDS. The nurse would not contact the grieving​ parents' other children to discuss the​ infant's death.

What areas of the health history should the nurse focus on when assessing an infant for​ SIDS? (Select all that​ apply.) 1. Exposure to smoke 2. Maternal history of miscarriage 3. Breathing patterns 4. Family history of SIDS 5. Sleep patterns

1, 3, 4, 5

Which neurovascular assessment findings are found in client with a​ fracture? ​(Select all that​ apply.) 1. Paralysis 2. Perspiration 3. Pulselessness 4. Pain 5. Paresthesia

1, 3, 4, 5

What is the main pathology of Parkinson disease that causes changes in muscular and sensory​ function? 1. Reduction of dopamine in the brain 2. Presence of Lewy bodies 3. Genetic predisposition 4. Reduction of acetylcholine in the brain

1. Reduction of dopamine in the brain

Juanita Botella is a​ 30-year-old woman who is pregnant with her first child. She has decided to take a prenatal class offered at the local hospital on the risks and prevention of sudden infant death syndrome​ (SIDS). In​ class, Mrs. Botella admits to smoking half of a pack of cigarettes every other day. What other health history factor would place Mrs.​ Botella's infant at higher risk for​ SIDS? 1. SIDS within family 2. Gestational diabetes 3. Previous miscarriage 4. Placenta previa

1. SIDS within family

A nurse is assessing a client with Parkinson disease. The nurse monitors the client for which potential complications of Parkinson​ disease? ​(Select all that​ apply.) 1. Pressure ulcers 2. Excessive sleeping 3. Choking 4. Falls 5. Impaired memory

1, 3, 4, 5 The client with Parkinson disease has an unsteady gait because of rigidity and the trunk leaning forward. This causes the client to be at increased risk for falls. The client with Parkinson disease has problems with physical mobility due to rigidity. This causes the client to be at higher risk for pressure ulcers. The client with Parkinson disease has difficulty swallowing and tremors that interfere with eating. This can lead to​ choking, malnutrition, and weight loss. Weight measured on a weekly basis will help give information about the client​'s nutritional status. Clients with Parkinson disease have memory loss caused by neuron degeneration. The client may also have slowed thinking and an inability to solve problems. The client may have paranoid thinking as a complication of dementia. Clients with Parkinson disease typically have difficulty sleeping from loss of dopamine and from unopposed acetylcholine. Some Parkinson medications also cause difficulty sleeping. The nurse would monitor for inability to sleep rather than excessive sleeping.

A nurse is caring for a couple that is grieving over the death of their​ infant, who is suspected to have died as a result of sudden infant death syndrome​ (SIDS). Which responses made by the nurse support the couple​'s psychosocial needs and provide the couple with collaborative therapy​ resources? (Select all that​ apply.) 1. Is there a pastor or clergy member you would like me to ​call? 2. What funeral home would you like me to ​contact? 3. I will provide you with a list of local grief counselors. 4. The infant loss support group meets every Tuesday. 5. "I am sorry you are going through this. Would you like to talk to me about your ​child?

1, 3, 4, 5 The nurse who is supporting the​ couple's psychosocial needs and providing the couple with collaborative therapy resources will assist the family in contacting the​ family's pastor or clergy​ member, provide the family with resources on grief counselors and support​ groups, and provide empathy toward the​ infant's family. Asking the family about funeral homes is not supportive and the family may not be ready to discuss this.

A healthcare provider is concerned about soft tissue injury for a client with an ulnar fracture. Which tests would be used to diagnose this client​'s soft tissue​ injuries? ​(Select all that​ apply.) 1. Complete blood count 2. Bone scan 3. ​X-ray 4. MRI 5. CT scan

1, 4, 5 A computed tomography scan​ (CT) provides a​ three-dimensional picture used to evaluate the extent of bone involvement and to what extent the surrounding soft tissues and neurovascular structures are affected. A magnetic resonance image​ (MRI) uses radio waves and magnetic fields.​ Gadolinium, an injected contrast​ media, is used to enhance the visualization of bony and soft tissues. The exam is used to evaluate the bone damage and to determine the amount of soft tissue and neurovascular involvement. A complete blood count and other blood tests can help assess if there is blood loss and tissue damage at the site of injury. An​ x-ray shows the location of the bone fracture and the extent of bone involvement. A bone scan detects the extent of the bone​ fracture, and detects whether or not the bone has adequate blood supply. These tests do not show soft tissue involvement.

A client is taking​ carbidopa-levodopa (Sinemet) to help control the manifestations of Parkinson disease. The client is experiencing brief periods of sudden onset of manifestations followed by a return to improved function. What is causing this sudden change in​ manifestations? 1. Adverse effects 2. Ondash-off phenomenon 3. Medication withdrawal 4. Low medication levels

2 Sinemet can cause episodes of manifestations followed by return to improved​ function, also known as the​ on-off phenomenon. These episodes can last from minutes to hours. This can sometimes be prevented by increasing the number of doses per day. Medication withdrawal can cause severe muscle​ rigidity, tremor, and mental changes. The manifestations do not improve until the drug is administered and enters the client​'s blood stream. Insufficient blood levels cause poorly controlled manifestations. The manifestations do not improve until medication is administered. Adverse effects of Sinemet include involuntary​ movement, suicidal thoughts and euphoria. These manifestations do not improve until the medication is stopped.

Which term describes a physical condition with an invasion by​ microorganisms, but no clinical evidence of​ disease? 1. Subclinical infection 2. ​Healthcare-associated infection 3. Virulence 4. Opportunistic pathogen

1. Subclinical infection

What are risk factors for the development of​ bronchiolitis? ​(Select all that​ apply.) 1. Age 4 or older 2. Premature birth 3. Attends daycare 4. Chronic lung disease 5. Cigarette smoke exposure

2, 3, 4, ,5

Mrs. Beal is a​ 75-year-old widow who was diagnosed with Parkinson disease. She moves slowly with a shuffling gait and speaks in a slurred manner with poor articulation. She tries to speak louder to accommodate for this impairment. She uses a walker. She has involuntary movements of her shoulders and arms and has difficulty with ADLs that require fine motor control. Her daughter is her primary caregiver. Mrs. Beal tells you that she has had to rely more and more on her daughter to help her with everyday tasks. She​ states, "I catch my daughter looking at me angrily​ sometimes, but she​ doesn't say anything. I try to stay out of her way when I​ don't need her​ help." What is her priority risk based on this​ information? 1. Caregiver role strain 2. Nutrition deficit 3. Falls 4. Impaired communication

1. Caregiver role strain

Which are clinical manifestations of a​ fracture? ​(Select all that​ apply.) 1. Fluid excess 2. Muscle spasms 3. Swelling 4. Crepitus 5. Ecchymosis

2, 3, 4, 5

Which behaviors are considered protective against sudden infant death syndrome​ (SIDS)? (Select all that​ apply.) 1. Prone positioning 2. Use of pacifier while sleeping 3. Use of sleeper pajamas 4. Breastfeeding 5. Neutral ambient room temperature

2, 3, 4, 5

Which complication of a fracture causes​ dyspnea? 1. Fat embolism 2. Deep vein thrombosis 3. Infection 4. Compartment syndrome

1. Fat embolism

Which clinical manifestations would be required to confirm a diagnosis of Parkinson​ disease? 1. Tremors at rest and bradykinesia 2. Tremor at rest and flaccidity 3. Bradykinesia only 4. Rigidity only

1. Tremors at rest and bradykinesia

​Four-year-old Grayson Mills has just been diagnosed with a mild case of bronchiolitis. What action should the nurse take to help Grayson at this​ time? 1. Use a humidifier to cool the air 2. Administer ribavirin as prescribed 3. Administer palivizumab as prescribed 4. Use an inhaled bronchodilator as prescribed

1. Use a humidifier to cool the air

What is the correct order of the steps in the chain of​ infection, after the presence of a​ microorganism, but before it gets to the susceptible​ host? ​ Method of transmission Reservoir Portal of entry Port of exit

1st Reservoir 2nd Port of exit 3rd Method of transmission 4th Portal of entry

A novice nurse is working independently on a​ maternal-newborn unit after 12 weeks of orientation with a preceptor. The nurse is assigned several newborns to care for during the shift. Based on the clinical pathway for a mother and baby of a vaginal​ birth, which intervention by the nurse is​ appropriate? 1. Administering vitamin K to the mother within 24 hours of delivery 2. Scheduling bottle feedings for the newborn of 15 to 30 mL every 4 hours at 24 hours of life 3. Ensuring the newborn is breastfed 6 times per day at 48 hours of life 4. Administering erythromycin ointment to the newborn​'s eyes at 48 hours of life

2 Based on the clinical pathway for the mother and newborn after a vaginal​ delivery, the most appropriate intervention is to schedule bottle feedings for the infant every 4 hours​ (6 times per​ day) at 24 hours of life. These feedings should consist of 15 to 30 mL of infant formula. Vitamin K is administered to the​ newborn, not the​ mother, within 24 hours of delivery. Erythromycin ointment is administered to the​ newborn's eyes within 24 hours of delivery. Newborns who are breastfed should be offered the breast 8 times per day at 48 hours of​ life, not 6 times per day.

The nurse is administering pain medication to a client with a radial fracture. The client asks what the difference is between the opioids being administered and the NSAIDs that the client is used to taking. What is the best response by the​ nurse? 1. ​"Only opioids can be given with a​ patient-controlled pump." 2. ​"Unlike NSAIDs, opioids will only be given to you for a limited period of​ time." 3. ​"Only opioids can be given at a scheduled time around the​ clock." 4. ​"Unlike NSAIDs, you should request opioids before your pain becomes​ severe."

2 Both NSAIDs and opioids can be given with a​ patient-controlled analgesic​ (PCA) pump, given at scheduled times around the​ clock, and be requested by the client before pain becomes severe. Unlike​ NSAIDs, opioids will only be prescribed for a certain period of time to prevent addiction.

A client is admitted with a right radial and ulnar fracture after a motorcycle crash. The nurse is concerned that the client may have neurovascular dysfunction. What would the nurse assess to determine if the client has neurovascular​ dysfunction? 1. History of the traumatic event 2. The 5 P​'s 3. The ABCs 4. Chronic illness

2 Clients with fractures have problems with acute​ pain, an increased risk of​ infections, mobility​ problems, and an increased risk for neurovascular dysfunction. To assess for neurovascular dysfunction the nurse would support the injured extremity when​ moving, assess the 5 P​'s ​(pain, pulses,​ pallor, paralysis, and​ paresthesia), assess the nailbeds and capillary​ refill, monitor for​ edema, assess for increased​ pain, and monitor the tightness of the cast. The nurse would assess the history of traumatic​ event, chronic​ illness, and the ABCs during the health history​ assessment, but these would not assist in assessing for neurovascular dysfunction.

The school nurse teaches a group of daycare teachers on the manifestations of respiratory syncytial virus​ (RSV). Which teacher​'s statement indicates that additional instruction is​ required? 1. "Rapid breathing is not normal and needs to be checked out 2. Most babies are irritable when they miss their mothers. 3. Vomiting and diarrhea need to be investigated. 4. I have to report any child that has a change in eating pattern.

2 One manifestation of RSV is irritability. Believing that most babies are irritable because they miss their mothers indicates additional teaching is required.​ Vomiting, diarrhea, rapid​ breathing, and a change in eating pattern are all manifestations of RSV and need to be reported and investigated.

The nurse is providing care to several clients in the emergency​ department: A client who arrived by ambulance with stroke​ symptoms; a client with a fractured​ femur; a client complaining of​ sharp, continuous pain radiating from the kidney​ area; and a young child with a possible fractured arm whose mother is with him. Using the urgency​ factor, which client will the nurse prioritize for​ care? 1. The client with​ sharp, continuous pain radiating from the kidney area 2. The client with stroke symptoms 3. The young child with the possible arm fracture 4. The client with a fractured femur

2 Prioritizing client care can be approached by various methods. Criteria that impact the urgency factor include changes in the​ client's condition, deterioration of client​ status, or complexity of the​ client's condition. Imminent death is the highest urgency factor where interventions need to be addressed immediately in order to save a​ client's life. The client with stroke symptoms is at risk of imminent death or substantive impairment and must be seen immediately. The client experiencing kidney pain is considered​ medium-high urgency because the condition may become life threatening if not assessed and addressed quickly. Sprains and fractures are less urgent.

A​ 3-year-old child is admitted in December with severe bronchiolitis. Which question should the nurse include when reviewing the child​'s health history with the​ parents? 1. "At what age was the child potty ​trained? 2. "Did the child have an annual influenza ​vaccination? 3. "How much fluid does the child drink each ​day? 4. "When did the child begin to walk without ​help?

2 The influenza virus is one cause for the development of bronchiolitis. Because of​ this, the nurse needs to assess if the child had an annual influenza inoculation to rule out the cause for this health problem. The age that the child was potty trained does not impact the development of bronchiolitis. The amount of fluid that the child ingests and the age in which the child began to walk also do not impact the development of bronchiolitis.

A nurse is caring for a couple whose infant son recently died from sudden infant death syndrome​ (SIDS). The infant​'s father appears withdrawn and refuses to acknowledge the infant​'s death when the nurse discusses the infant with the couple. Which collaborative therapy is most appropriate to help the infant​'s family in the grieving​ process? 1. Cognitive behavioral therapy 2. Grief counseling 3. Antidepressant medication 4. Antianxiety medication

2 The nurse should address the​ family's psychosocial needs at the time of grieving. The nurse should recommend grief counseling to the family of the infant. Cognitive behavioral​ therapy, antidepressant​ medication, and antianxiety medications are all therapies that must be ordered by the healthcare provider and the appropriate nurse will not recommend these.

The nurse is providing care to a​ 1-year-old pediatric client who is admitted to the emergency department with​ SaO2% of​ 93% on room​ air, respiratory rate of 50 breaths per​ minute, with moderate wheezing. Based on the pediatric clinical pathway for​ asthma, what intervention does the nurse anticipate for this​ client? 1. IV corticosteroids 2. Nebulizer treatment of albuterol 3. Continuous anticholinergic medication administration 4. Systemic magnesium sulfate

2 The pediatric client is experiencing a mild asthma attack. Based on the clinical​ pathway, the nurse anticipates the client will be given a nebulizer treatment of a beta adrenergic​ medication, such as albuterol. Systemic magnesium​ sulfate, IV​ corticosteroids, and continuous administration of anticholinergic medications are not appropriate for a pediatric client experiencing a mild asthma​ attack, per the clinical pathway.

A nurse has completed teaching for an older adult male client and his wife about placement of a deep brain stimulator. Which statement by the wife indicates a need for further​ instruction? 1. ​"This device helps block a chemical in my husband​'s ​brain." 2. ​"This device means my husband won​'t have to take medication​ anymore." 3. ​"The device does not cure Parkinson​ disease." 4.​"The device makes electrical impulses to stimulate his​ brain."

2 The statement​ "This device means my husband won​'t have to take medication​ anymore" indicates that the wife needs further instruction concerning the brain stimulator. Clients who have a deep brain stimulator placed may still need low doses of medication. The stimulator does not completely control the​ manifestations, such as tremors. The statement​ "The device does not cure Parkinson​ disease" indicates that the wife understands the procedure and does not need further instruction. The stimulator does not cure Parkinson disease. It will help control tremors in clients who are not receiving sufficient control with medications. The statement​ "The device makes electrical impulses to stimulate his​ brain" indicates that the wife understands how the stimulator works. The deep brain stimulator creates electrical impulses that stimulate the brain in specific areas. The impulses block the effects of acetylcholine that cause the tremors. The statement​ "This device helps block a chemical in my husband​'s ​brain" indicates that the wife understands the stimulator will act to block the chemical​ acetylcholine, which is causing the client​'s tremors.

The nurse prioritizing care for a client with diabetes mellitus utilizes Maslow​'s hierarchy of needs. Which need is priority for this​ client? 1. The client attends classes to deal with body image after amputation of right leg. 2. The nurse teaches the client how to properly change dressings on right leg amputation site. 3. The nurse teaches the client proper home safety techniques to prevent diabetic wounds. 4. The client joins the local American Diabetes Association support group.

2 When prioritizing care based on​ Maslow's hierarchy of​ needs, physiological needs will come before​ safety, social, and esteem needs. Caring for an amputation site is meeting a physiological need. Attending a class to deal with body image issues addresses an esteem need. Teaching the client about safety techniques to prevent diabetic wounds addresses a safety need. Joining a support group meets an esteem need.

The urgent care clinic nurse referred a client with an acute bacterial infection to see a dermatologist. Which diagnosis is the most likely possibility for this​ client? 1. Conjunctivitis 2. Cellulitis 3. Otitis media 4. Sepsis

2 ​Cellulitis, an acute bacterial infection of the​ dermis, could result in a referral to a dermatologist. Conjunctivitis is an infection in the eye. Otitis media is an infection in the ear. Sepsis is an infection in the whole body.

A nurse is caring for a couple whose infant has died. The healthcare provider suspects the death is a result of sudden infant death syndrome​ (SIDS). When asking the couple about the circumstances surrounding the infant​'s ​death, what factors will the nurse focus​ on? ​(Select all that​ apply.) 1. Health of the couple 2. History of infant congenital heart defects 3. Infant​'s dietary intake 4. Health of the infant 5. History of infant reflux

2, 3, 4 Interviews of the family focus on determining the circumstances surrounding the​ infant's death. Questions center on the health of the​ Infant, dietary​ intake, and history of congenital birth defects. Health of the couple and history of infant reflux do not help to determine the circumstances surrounding the​ infant's death, as these factors have not been linked to causing​ SIDS-related deaths.

The nurse is providing education to a pregnant client who has asked for information regarding risk factors related to sudden infant death syndrome​ (SIDS). Which statements by the nurse are​ appropriate? ​(Select all that​ apply.) 1. If your child is​ female, the risk for SIDS increases. 2. If your child is born​ premature, the risk for SIDS increases. 3. If your child is exposed to smoke in the​ home, the risk for SIDS increases. 4. If your child shares your bed during​ sleep, the risk for SIDS increases. 5. If your family has a history of​ SIDS, the risk for SIDS increases.

2, 3, 4, 5 The incidence of​ SIDS-related deaths is greater among males than females. Additional factors that increase the risk of SIDS include infant​ prematurity, infant exposure to​ smoke, co-sleeping, and a family history of SIDS.

Which areas of the body are protected from infection by​ fluids? (Select all that​ apply.) 1. Vagina 2. Eye 3. Urethra 4. GI system 5. Mouth

2, 3, 5

A nurse is performing passive range of motion exercises for a client with Parkinson disease. Which nursing goals does this intervention​ address? ​(Select all that​ apply.) 1. The client will demonstrate normal bowel elimination patterns. 2. The client will remain free from injury. 3. The client will participate in speech therapy for swallowing and verbal communication. 4. The client will participate in physical therapy to improve walking and balance. 5. The client will participate in occupational therapy to integrate assistive devices for​ self-care.

2, 4 Physical​ therapy, including passive range of motion​ (ROM) exercises will improve the​ client's walking and balance. This in turn helps prevent injury from falls. Assistive devices related to occupational therapy are different from those related to physical therapy. The occupational therapist would teach about devices that facilitate activities of daily living such as button hooks and communication​ boards, not devices that assist with walking and balance. Passive ROM exercises are not related to speech therapy or promoting normal bowel elimination patterns.

What statements concerning bone fractures are​ correct? ​(Select all that​ apply.) 1. Diseases such as neoplasms do not cause bone fractures. 2. The severity of a bone fracture depends on the force of the action against the bone and bone strength. 3. Bone fractures do not result from low bone density. 4. A bone fracture can be the direct result of excess pressure in the fibrous membrane or fascia. 5. Bone fractures may result from repetitive forces or twisting.

2, 5

What​ risk-reduction factor should be included in the collaborative teaching of preventing​ SIDS? 1. Keep nursery temperature cooler than living space 2. Encourage tummy time for play 3. Encourage prone positioning for sleep 4. Use only one loose blanket in​ infant's crib

2. Encourage tummy time for play

What is the identifiable cause of sudden infant death syndrome​ (SIDS)? 1. Infant prematurity 2. No known etiology 3. Respiratory distress syndrome 4. Congenital anomaly

2. No known etiology

​Six-year-old Kerry Teng has been diagnosed with bronchiolitis. What will the nurse include when assessing​ Kerry? 1. Observe for signs of obstruction 2. Observe for labored respirations 3. Assess for seizures 4. Monitor closely for lengthening of paroxysms

2. Observe for labored respirations

Which is a preventive measure for​ bronchiolitis? 1. Sputum culture 2. Palivizumab 3. Antibiotic therapy 4. Immunization

2. Palivizumab

What will prevent the spread of infection when a child with respiratory syncytial virus​ (RSV) is admitted to a care​ area? 1. Perform frequent handwashing 2. Prohibit contact between clients with and without RSV 3. Cover the child​'s face with a mask 4. Admit to the intensive care unit

2. Prohibit contact between clients with and without RSV

Which central nervous system symptom might occur in a severe infection in a​ newborn? 1. Back pain 2. Seizures 3. Muscle weakness 4. Stiff neck

2. Seizures

Eighteen month old Jeremy Young is brought to the emergency department by his mother. After seeing​ Jeremy, the nurse suspects Jeremy has bronchiolitis. What manifestation did Jeremy demonstrate for the nurse to come to this​ conclusion? 1. Bruising 2. Wheezing 3. Cool skin 4. Diarrhea

2. Wheezing

Mr. Watson is a​ 40-year-old man diagnosed with Parkinson disease. He is surprised by the diagnosis despite having trouble with his balance for several months. He also states that he has been having trouble talking and has problems resting at night. Mr. Watson says his father had Parkinson​ disease, but he was told it was not hereditary. What is your best​ response? 1. ​"It is not​ genetic, but it usually affects men more often than​ women." 2. ​"It is believed to have a genetic​ link, especially in those who get the disease before the age of 50​ years." 3. ​"There is no evidence it is​ genetic, but it affects 4 million people a​ year, so you are not​ alone." 4. ​"It is believed to be​ genetic, but only 15 to​ 25% of the people who are diagnosed have a family history on their​ mother's side."

2. ​"It is believed to have a genetic​ link, especially in those who get the disease before the age of 50​ years."

A client with Parkinson disease is unable to communicate because of a soft voice and poor facial muscle strength. The nurse anticipates a referral for which member of the interdisciplinary​ team? 1. Physical therapist 2. Occupational therapist 3. Speech therapist 4. Respiratory therapist

3 A speech therapist will work with the client to improve speech with exercises. The client may not have sufficient strength in the​ face, throat, and respiratory muscles to produce audible sounds. The speech therapist may recommend a communication board​ ("magic slate") to help the client communicate his or her needs to others. The client has poor breath support and a soft voice because of impaired muscular strength. A respiratory therapist will not be able to effectively treat these problems. Respiratory therapists give breathing treatments and perform chest percussion to treat congestion in the lungs. The occupational therapist treats​ self-care deficits such as grooming and dressing. The physical therapist treats coordination and ambulation problems. This client has difficulty with speech because of a soft voice and poor facial muscle strength.

The mother of a child diagnosed with bronchiolitis caused by respiratory syncytial virus​ (RSV) is upset to learn that the child will be admitted to a​ semi-private room. Which explanation by the nurse is the most appropriate regarding this room​ assignment? 1. The children will have companionship when the parents are not able to visit. 2. The nurse can provide care to both children at the same time. 3. RSV is​ contagious, however placing two children with the same illness is permissible. 4. RSV is not contagious so the roommate will not contract the illness.

3 Because RSV is highly​ contagious, pediatric clients with RSV are isolated or roomed with other pediatric clients who also have RSV. The child is not being placed in a​ semi-private room to make it easier for the nurse to provide care. Because RSV is​ contagious, placing two children together in the same room is permissible. The children are not being placed together for companionship.

A nurse is caring for a client who delivered a​ healthy, term baby girl 8 hours ago. The nurse is providing the client information about sudden infant death syndrome​ (SIDS) as a part of discharge instructions. The client asks the​ nurse, "Why does breastfeeding help to prevent my child from developing​ SIDS?" Which response by the nurse is the most​ appropriate? 1. ​"Breastfed infants are thought to be larger than infants who are fed​ formula." 2. ​"Breastfed infants are thought to sleep longer than infants who are fed​ formula." 3. ​"Breastfed infants are thought to arouse easier from sleep than infants who are fed​ formula." 4. ​"Breastfed infants are thought to breathe easier than infants who are fed​ formula."

3 Breastfed infants are thought to arouse easier from sleep than infants who are fed formula.​ This, in​ turn, decreases the risk for the infant to develop SIDS. The other responses are incorrect.

A client is diagnosed with a comminuted fracture. How would the nurse describe this fracture to the​ client? 1. ​"The ends of the broken bones are forced​ together." 2. ​"The bone is breaking through the​ skin." 3. ​"The bone is broken into many​ pieces." 4. ​"The fracture travels horizontally across the bone​ shaft."

3 In a comminuted​ fracture, the bone is broken in many pieces. The bone fragments may cause further injury or complications. An open or compound fracture involves bone breaking through the skin. A transverse fracture is horizontal to the bone shaft. In an impacted or buckle​ fracture, the ends of the broken bones are forced together.

The lack of automatic muscle movement may cause which potential problem for the client with Parkinson​ disease? 1. Diminished voice volume 2. Diminished physical mobility 3. Alterations in sleep pattern 4. Reduced ability to swallow

3. Alterations in sleep pattern

A home health nurse is visiting a client who recently delivered a​ healthy, term baby boy. The nurse is providing postpartum care and observation of the newborn. The client tells the​ nurse, open double quote"I think my son sleeps longer when he is placed on his tummy for naps.close double quote" What response by the nurse is most​ correct? 1. It is fine to place your son on his tummy for naps as long as you are in the same room with him. 2. It is fine to place your son on his tummy for naps but not for sleep at night. 3. It is not acceptable to place your son on his tummy for sleep because this can make your son lose his protective reflexes. 4. It is not acceptable to place your son on his tummy for sleep because this can make your son spit up and he can aspirate.

3 The nurse should educate the client that placing her child on his tummy to sleep is not acceptable at any​ time, whether during naps or at night. Placing the child on his tummy​ (prone positioning) while sleeping increases the risk of the infant losing his protective reflexes​ (head turning and​ arousal) that are normally triggered with asphyxia.

A nurse on the inpatient rehabilitation unit is providing care for an older male client with Parkinson disease. The nurse monitors the client while he is eating a sandwich and reminds the client of which strategies to facilitate​ self-feeding? 1. Respiratory therapy 2. Occupational therapy 3. Speech therapy 4. Physical therapy

3 The nurse should help the client implement speech therapy strategies to facilitate eating. Physical therapy focuses more on mobility and occupational therapy focuses more on activities of daily living. Respiratory therapy would only be performed if the client had a compromised airway. While choking is a risk for the client with Parkinson​ disease, there is no evidence that the client is choking.

The home care nurse is visiting a client who reports symptoms of a severe respiratory infection. Which characteristic about the onset of symptoms would the nurse know as consistent with a diagnosis of viral​ pneumonia? 1. Remitting onset of symptoms 2. Subclinical onset of symptoms 3. Gradual onset of symptoms 4. Acute onset of symptoms

3 With viral​ pneumonia, symptom onset is​ gradual, not acute. Onset is neither subclinical nor remitting.

A nurse is preparing a presentation on Parkinson disease for a health fair at a local community center. What would the nurse include in this​ presentation? ​(Select all that​ apply.) 1. Parkinson disease is inherited in over​ 50% of those affected. 2. Parkinson disease is the result of an infection. 3. Parkinson disease usually affects people older than the age of 60 years. 4. Parkinson disease affects at least​ 500,000 individuals in the United States. 5. Parkinson disease affects both men and women at the same rate.

3, 4 Parkinson disease affects at least​ 500,000 individuals in the United States​ alone, with​ 50,000 new cases in the United States each year. Parkinson disease is more common in people older than the age of 60 years. Parkinson disease can also occur in younger​ people, but this is less common. Parkinson disease affects men more than women. The cause of Parkinson disease is not known. It is inherited in only​ 15-25% of cases. There is no evidence of an infection that causes Parkinson disease.

The​ client, a chemistry graduate​ student, was interested in the urgent care clinic​ nurse's talk about the human​ body's natural protection from infection. The nurse talked about low pH and high acidity prevent microbial growth. Which areas of the body have this​ protection? ​(Select all that​ apply.) 1. Lungs 2. Eye 3. Stomach 4. Vagina 5. Mouth

3, 4 The low pH of the vagina and the​ stomach's high acidity prevent microbial growth. This is not true for the​ eye, mouth, or lungs.

Jillian Adichie is a​ 16-year-old girl who fell from a balance beam at a practice meet and landed off the mat onto some protruding hardware. She fractured her left leg. In assessing​ Jillian's leg, you notice that the area above her ankle is warm and at an odd angle and the skin is broken. Based on this assessment​ alone, how would you initially classify this​ injury? 1. Complete 2. Incomplete 3. Open​ (compound) fracture 4. Closed​ (simple) fracture

3. Open​ (compound) fracture

Which nonpharmacologic therapy is appropriate for a child with respiratory syncytial virus​ (RSV)? 1. Providing three full meals each day 2. Taking the child to the playroom to socialize 3. Organizing care to allow for rest 4. Suctioning the airway every hour

3. Organizing care to allow for rest

Which therapy for fractures applies a straightening or pulling force to return or maintain the fractured bones in normal anatomic​ position? 1. Cast 2. Splint 3. Traction 4. Electrical bone stimulation

3. Traction

During a postnatal home health​ visit, you teach Ms.​ Henderson, a​ 31-year-old woman, about the importance of supine positioning for infant sleep for the prevention of SIDS. Ms. Henderson tells you that her infant does not like sleeping on his back and only sleeps on his tummy. What is your best response when explaining to Ms. Henderson the importance of supine positioning for infant​ sleep? 1. ​"This position decreases aspiration should your baby spit​ up." 2. ​"This position will allow your child to sleep​ longer." 3. ​"This position is protective in preventing​ suffocation." 4. ​"This position prevents digestive​ problems, which can contribute to​ SIDS."

3. ​"This position is protective in preventing​ suffocation."

Which radiologic study is the best method to diagnose a​ fracture? 1. MRI 2. Bone scan 3. ​X-ray 4. CT scan

3. ​X-ray

A nurse is caring for a pregnant client during a routine prenatal visit. While performing the​ assessment, which statement by the client may indicate the infant is at a greater risk for sudden infant death syndrome​ (SIDS)? 1. ​"My father was diagnosed with diabetes last​ year." 2. ​"I miscarried my fist pregnancy at ten​ weeks." 3. "I delivered my first baby​ vaginally." 4. ​"My sister died during infancy while we were​ sleeping."

4 A familial history of SIDS increases the risk of​ SIDS-related death in the pregnant​ client's child. Having a family member with​ diabetes, experiencing a miscarriage at the 10th week of​ pregnancy, and delivering a child vaginally do not increase the risk of SIDS.

A nurse carefully records the time of administration of vancomycin to the client. The nurse works with the lab technician to schedule blood draws at several specific intervals. What facts do these lab test results give to the healthcare​ team? 1. Lumbar puncture 2. Culture and sensitivity 3. White blood cell count 4. Antibiotic peak and trough levels

4 Blood is drawn at specific intervals after administration of vancomycin to measure antibiotic peak and trough levels. Other​ tests, such as culture and​ sensitivity, lumbar​ puncture, and white blood cell​ count, are not involved.

A​ client, newly diagnosed with Parkinson​ disease, asks the nurse what dopamine does in the brain. What is the appropriate response by the​ nurse? 1. "Dopamine causes spinal cord neurons to transmit​ impulses." 2. ​"Dopamine stimulates the neurons to transmit sensory and motor​ impulses." 3. ​"Dopamine enhances the action of​ acetylcholine." 4. ​"Dopamine helps maintain coordinated motor​ movement."

4 Dopamine is responsible for coordination. It balances the neurotransmitter​ acetylcholine, which stimulates the neurons. Dopamine prevents this stimulation from becoming excessive. Dopamine provides regulation rather than stimulation. Dopamine regulates motor neuron impulses and balances acetylcholine. Dopamine only works on certain brain neurons located in the basal​ ganglia, not the spinal cord. Dopamine minimizes and balances the effects of​ acetylcholine, not enhances it.

The nurse is preparing a plan of care for an infant diagnosed with acute bronchiolitis due to respiratory syncytial virus​ (RSV). Which nursing diagnosis should the nurse select to guide this infant​'s ​care? 1. Potential for tissue perfusion changes 2. Alteration in cardiac output 3. Impaired pain response 4. Reduced activity tolerance

4 Reduced activity tolerance is a problem during an acute phase of bronchiolitis because of the imbalance between oxygen supply and demand. Cardiac output is not altered during an acute phase of bronchiolitis. Pain response is not impaired because pain is not usually associated with acute bronchiolitis. Tissue perfusion is not changed because this perfusion is not affected by this respiratory disease process.

The parents of a newborn child are concerned about bringing the baby home to a household of relatives with various illnesses. For how many weeks can the obstetrical nurse tell the parents that their child is protected by the​ mother's immunoglobulins? 1. 4 to 7 weeks 2. 1 to 3 weeks 3. Under one week 4. 8 to 12 weeks

4 The child is protected by the​ mother's immunoglobulins for 8 to 12 weeks.

The nurse is caring for several clients during a shift. Which observation made during a nursing assessment would be​ priority? 1. A client with an oxygen saturation of​ 94% 2. A client with a BP of​ 96/54 mmHg, HR of 70​ bpm, RR of 20 breaths per​ minute, and T 97.6​°F 3. A client who begins coughing after 6 minutes of walking 4. The client who complains of shortness of breath when walking from room to room

4 The first step when prioritizing care is assessment. Assessment is the process of gathering information to make decisions. At all​ times, the nurse needs to be aware that​ airway, breathing, and circulation are vital for life. The client who is complaining of shortness of breath when walking from room to room may have airway​ issues: This is the priority. The other clients may require​ interventions, but the client with shortness of breath takes priority.

A nurse is involved in investigating the death of an infant. A​ SIDS-related death is suspected. What is true regarding the process of investigating this type of​ death? 1. The focus of the investigation is to determine blame for the​ infant's death. 2. The focus of the investigation is on the​ infant's parental behavior. 3. The focus of the investigation does not involve the​ infant's family. 4. The focus of the investigation involves determining the cause of infant death.

4 The focus of the investigation involves determining the cause of infant death. The investigation does not focus on parental​ behavior, or blame for the​ infant's death. The investigation does involve the​ infant's family.

Which describes a risk factor of Parkinson disease​ (PD)? 1. Affects city dwellers more than those in rural areas 2. Affects women more often than men 3. ​Late-onset is more likely to have a genetic link 4. Age is the primary risk factor

4. Age is the primary risk factor

After delivering a healthy baby boy 2 days​ ago, 32-year-old Erica Chambers is now being discharged after a brief hospitalization. The nurse is providing discharge teaching to Ms. Chambers regarding the prevention of SIDS. Which statement by the nurse is not correct and will not be included in the discharge​ teaching? 1. ​"Do not allow anyone to smoke around your​ baby." 2. ​"Place your baby on his back to​ sleep." 3. ​"Breastfeeding is preferred over formula for your​ baby." 4. ​"Keep your​ baby's nursery temperature at 85​ degrees."

4. ​"Keep your​ baby's nursery temperature at 85​ degrees."

Len Erickson is a​ 55-year-old rancher who was involved in a motor vehicle accident that caused severe soft tissue damage to his left leg and an open tibial fracture. Mr. Erickson says the surgeon was just in and told him that he would need surgery to fix his leg using external fixation. He asks you what that means. What is your best​ response? 1. ​"Your leg has a lot of tissue damage so we have to use external fixation to fix​ it." 2. ​"Wires and screws will be attached directly to your bones to put them back​ together." 3. ​"External fixation has a shorter hospital stay than internal​ fixation, which is why​ we're using​ it." 4. ​"You will have metal rods attached to your leg on the outside until the bone​ heals."

4. ​"You will have metal rods attached to your leg on the outside until the bone​ heals."

Which medication is only used to treat severe case of respiratory syncytial virus​ (RSV)? 1. Aceteminophen 2. Racemic epinephrine 3. Prednisone 4. Ribivarin

4. Ribivarin

Manuel Barreto is a​ 50-year-old man who presented to the emergency department with a broken right radius and ulna sustained when he fell on a patch of ice. You are assessing the 5​ P's and ask him to wiggle his fingers on his right arm. He asks why you are doing this. What would you include in your​ response? 1. ​"I am checking for​ paleness." 2. ​"I am checking for​ numbness." 3. ​"I am checking for​ pulse." 4. ​"I am checking for​ paralysis."

4. ​"I am checking for​ paralysis."