MB4

during a home visit, the nurse instructs a young mother to bottle-feed the baby in the upright position. which health problem will this position help to prevent this child from developing? a. otitis media b. sinus infection c. choking d. aspiration

a. otitis media

A pediatric home health care nurse is making an initial visit to assess the parenting style for a family in preparation for treating a child with drugs to reduce hyperactivity. Which approach should the nurse use for this assessment? A) Ask the parents, "How do you handle situations that require limit setting?" B) Ask the child, "What rule is hardest for you to obey?" C) Observe the parent interacting with the child for 5 minutes. D) Ask the parents, "What are the house rules?"

A) Ask the parents, "How do you handle situations that require limit setting?"

a client sustains a concussion during a motor vehicle accident and on admission is disoriented and restless. which nursing diagnosis label should receive top priority? a. risk for injury b. disturbed sensory perception (visual) c. dressing or grooming self-care deficit d. impaired verbal communication

a. risk for injury

The nurse is instructing a client who is prescribed ipratropium bromide (Atrovent) for asthma. What should be included in this client's teaching? Select all that apply. A) Take no more than the prescribed number of doses each day. B) Rinse the mouth after taking this medication. C) Take on an empty stomach. D) Take with meals or a full glass of water. E) Use hard candy or drink extra fluids to help with a dry mouth.

A) Take no more than the prescribed number of doses each day. E) Use hard candy or drink extra fluids to help with a dry mouth.

The nurse is evaluating care provided to a new mother whose infant is at risk for sudden death syndrome (SIDS). Evidence that care has been effective would be the mother expressing: A) The need to purchase loose-fitting sheets and blankets for the bed. B) A plan to quit smoking. C) The proper way to place the infant in the crib as being prone or side-lying. D) The reasons why bottle-feeding is preferred over breastfeeding.

B) A plan to quit smoking.

A client being treated for newly diagnosed schizophrenia will be discharged to the family home. The family is developing an image of the disease process and expectations of mental health professionals and has reached Stage 2 of family recovery. Which concepts are included in this stage of recovery? Select all that apply. A) Coping B) Problem solving C) Acceptance D) Recognition E) Personal and political advocacy

B) Problem solving C) Acceptance D) Recognition

The nurse is determining the type of support the family of a client with newly diagnosed mood disorder is going to need. Which type(s) of support should the nurse consider to help this family? Select all that apply. A) Financial B) Professional C) Friend D) Family E) Spiritual

B) Professional C) Friend D) Family E) Spiritual

An adolescent with otitis media is experiencing extreme pain. Which should the nurse emphasize to address the diagnosis of Acute Pain for this client? A) Apply a cold compress to the affected ear. B) Report abrupt relief of pain immediately. C) Continue plans for air travel. D) Report increased pain when moving the outer ear.

B) Report abrupt relief of pain immediately.

The mother of a 5-month-old baby is concerned because the child has developed a runny nose, cough, and low-grade fever over the last few days. What do these signs suggest to the nurse? A) Meningitis B) Respiratory syncytial virus (RSV) bronchiolitis C) Bronchitis D) The common cold

B) Respiratory syncytial virus (RSV) bronchiolitis

The mother of an 8-month-old baby who has developed respiratory syncytial virus (RSV)/bronchiolitis wants to know what factors contribute to the risk of contracting RSV. What can the nurse tell this mother? A) "There is a higher risk in children who are being breastfed." B) "There is no way to avoid the illness." C) "There is a higher risk in children who are exposed to secondary cigarette smoke." D) "It is seen more frequently in children who do not attend daycare."

C) "There is a higher risk in children who are exposed to secondary cigarette smoke."

The nurse assesses fatigue in an infant with acute bronchiolitis due to respiratory syncytial virus (RSV). Which diagnosis would be most appropriate for the infant? A) Acute Pain B) Ineffective Tissue Perfusion C) Activity Intolerance D) Decreased Cardiac Output

C) Activity Intolerance

The nurse is teaching the parents of an infant with acute otitis media. What would be most important for the nurse to teach the parents? A) Administer a decongestant for nasal congestion. B) Keep the baby in a flat position during sleep. C) Administer acetaminophen to relieve pain and decrease fever. D) Place the baby to sleep with a pacifier.

C) Administer acetaminophen to relieve pain and decrease fever.

A new mother is distraught because her infant has a fever of 102ºF and is diagnosed with otitis media. What should the nurse instruct the mother to help the child's fever and pain? A) Swaddle the baby in blankets. B) Feed the baby solid foods. C) Administer acetaminophen. D) Bathe the baby with cool water.

C) Administer acetaminophen.

A client of Native American descent comes to the hospital in early labor at 23 weeks' gestation. The client's parents, sisters, and brothers are with her as well as her husband. The client's family insists on remaining with her during labor. Hospital policy, however, limits visitors to two. Which action is most appropriate for the nurse to take in this situation? A) Ask the parents of the baby what their needs are regarding the family request. B) Call security to escort the family out of the hospital. C) Speak with the nurse manager about supporting the family's wishes. D) Show the family to the waiting room.

A) Ask the parents of the baby what their needs are regarding the family request.

After reviewing the population demographics for an urban community, the community health nurse determines that community members would benefit from teaching on types 1 and 2 diabetes mellitus in children. What information caused the nurse to come to this conclusion? Select all that apply. A) 60% of community families have both parents diagnosed with type 2 diabetes mellitus. B) 35% of school-age children do not routinely receive the annual flu vaccination. C) 50% of children between the ages of 10 and 19 are African-American. D) 25% of children between the ages of 10 and 19 are Hispanic. E) 75% of school-age children are raised in families where both parents are unemployed.

A) 60% of community families have both parents diagnosed with type 2 diabetes mellitus. C) 50% of children between the ages of 10 and 19 are African-American. D) 25% of children between the ages of 10 and 19 are Hispanic.

The community nurse identifies that a family new to the community needs assistance with family dynamics and material resources. What should the nurse consider offering to the parents of this family to support their needs? Select all that apply. A) A list of free counseling services to assist with parental stress B) Hours of the local health clinic C) Location of the community library D) Location of the community co-op food bank E) Hours when the park is open

A) A list of free counseling services to assist with parental stress B) Hours of the local health clinic D) Location of the community co-op food bank

The Emergency Department nurse provided care to an infant that arrived in cardiac and respiratory arrest. The death of the infant was determined to be caused from sudden infant death syndrome (SIDS). The parents are grieving and will need collaborative interventions. The nurse is aware that which collaborative intervention would be appropriate for the parents? A) A psychosocial assessment B) A grief counselor referral C) A psychotherapist referral D) A visit from the chaplain

A) A psychosocial assessment B) A grief counselor referral C) A psychotherapist referral D) A visit from the chaplain

The student nurse attends a workshop on culture and diversity with regards to respiratory syncytial virus (RSV) and is now aware that RSV is a major cause of hospitalization among which group of infants? A) Alaskan Native infants B) African-American infants C) Native American infants D) Asian-American infants

A) Alaskan Native infants

The student nurse attends a workshop on culture and diversity with regard to sudden infant death syndrome (SIDS) and is now aware that the rate of occurrence is highest among which group of infants? A) American Indians B) African-Americans C) Asians D) Hispanics

A) American Indians

which interventions would be the most beneficial to decrease risk factors for a child who has had repeated admissions for respiratory syncytial virus (RSV) bronchiolitis? SATA a. do not smoke, and avoid all secondhand smoke around the child b. bathe the child frequently during the winter months c. encourage physical activity and play d. ensure an adequate nutritional intake e. instruct all care-givers of the importance of proper hand hygiene

?? a. do not smoke, and avoid all secondhand smoke around the child c. encourage physical activity and play d. ensure an adequate nutritional intake e. instruct all care-givers of the importance of proper hand hygiene

the nurse is creating a plan of care for the family of a client with a terminal illness. Which aspects of this family's care should the nurse emphasize when creating this plan? SATA a. instructing on medication administration b. focusing on the client's health needs as a priority c. suggesting that cultural practices be minimized at this time d. guiding to determine realistic goals e. identifying strategies to enhance family functioning

?? a. instructing on medication administration d. guiding to determine realistic goals e. identifying strategies to enhance family functioning

A nurse working on a pediatric unit is caring for an infant. The mother of the infant frantically calls the nurse into the room and states, "I believe my child is choking on a piece of candy." The nurse finds the infant and determines there is a total airway obstruction. Which is an appropriate action for the nurse to take? A) Attempt to clear the obstruction by delivering back blows and chest thrusts. B) Attempt to clear the obstruction by delivering back blows and chest compressions. C) Attempt to clear the obstruction by delivering back blows and abdominal thrusts. D) Attempt to clear the obstruction by delivering abdominal thrusts.

A) Attempt to clear the obstruction by delivering back blows and chest thrusts.

The nurse is concerned that a school-age child has undiagnosed type 1 diabetes mellitus and is experiencing diabetic ketoacidosis. What did the nurse assess in the client to come to this conclusion? Select all that apply. A) Blurred vision B) Irregular heartbeat C) Sunken eye sockets D) Sluggish bowel sounds E) Dry mucous membranes

A) Blurred vision B) Irregular heartbeat C) Sunken eye sockets E) Dry mucous membranes

Which interventions would be the most beneficial for the nurse to discuss with the parents of a child who has had repeated admissions for respiratory syncytial virus (RSV) bronchiolitis? Select all that apply. A) Do not smoke, and avoid all secondhand smoke around the child. B) Practice frequent hand washing. C) Encourage physical activity and play. D) Consider alternatives to sending the child to daycare. E) Ensure an adequate nutritional intake.

A) Do not smoke, and avoid all secondhand smoke around the child. D) Consider alternatives to sending the child to daycare.

A client with newly diagnosed otitis media tells the nurse that the left ear has been aching for weeks. Since this health problem has been untreated for so long, which additional problem is this client at risk for developing? A) External otitis B) Meningitis C) Pneumonia D) Influenza

A) External otitis

The clinic nurse is educating a group of new moms on the risk factors and prevention of respiratory syncytial virus (RSV). The nurse is aware that which action is the best way to prevent RSV? A) Hand washing B) Monitoring temperature C) Administering antibiotics D) Limiting fluid intake

A) Hand washing

The nurse is placing a newborn baby in the nursery crib with the baby's back down. The mother tells the nurse that she doubts the baby will be able to sleep that way, as all the family members sleep on their stomachs. What should the nurse do? A) Instruct the mother that placing the baby on the back will reduce the risk of sudden infant death syndrome (SIDS). B) Place the baby on the stomach. C) Suggest the mother place the baby on the stomach when at home. D) Instruct the mother that babies do not really care in which position they are in but placing on the back is easier to provide care.

A) Instruct the mother that placing the baby on the back will reduce the risk of sudden infant death syndrome (SIDS).

Which pharmacologic therapies may be expected in the treatment of RSV when the condition is less severe and the client is not immunocompromised? Select all that apply. A) Nebulized epinephrine B) Ribavirin C) Systemic corticosteroids D) Antibiotics E) Antipyretics

A) Nebulized epinephrine C) Systemic corticosteroids E) Antipyretics

A nurse is preparing to educate a group of parents on sudden infant death syndrome (SIDS). Which should the nurse include when presenting significant stressors that contribute to SIDS? Select all that apply. A) Prone sleeping B) Side sleeping C) Face-down sleeping D) Bed sharing E) Supine sleeping

A) Prone sleeping B) Side sleeping C) Face-down sleeping D) Bed sharing

What are some evidence-based interventions that could be most useful for an adolescent with asthma? Select all that apply. A) Provide the school with materials for group activities targeted towards students with asthma. B) Provide educational materials to the adolescent. C) Create a peer self-management program for adolescents with asthma. D) Counsel the adolescent's parents to restrict their child's interaction with other children to reduce stress.

A) Provide the school with materials for group activities targeted towards students with asthma. C) Create a peer self-management program for adolescents with asthma.

When assessing the risk of a newborn for SIDS, what are some of the factors the nurse should consider? Select all that apply. A) Race B) Gender C) Father's age D) Age E) Eye color

A) Race B) Gender D) Age

The Emergency Department nurse assessing an infant client would recognize which clinical manifestations as indications of possible respiratory syncytial virus (RSV)? Select all that apply. A) Rhinorrhea B) Irritability C) Grunting D) Bradypnea E) Tachypnea

A) Rhinorrhea B) Irritability C) Grunting E) Tachypnea

The nurse is planning care for a baby of African-American descent born to a mother who smoked during the pregnancy. Which diagnosis would be appropriate for this baby? A) Risk for Sudden Infant Death Syndrome B) Readiness for Enhanced Parenting C) Anxiety D) Deficient Knowledge

A) Risk for Sudden Infant Death Syndrome

The nurse working on a pediatric unit is caring for a client newly diagnosed with asthma. Which respiratory assessments findings may indicate this client is exhausted and will require immediate intervention? Select all that apply. A) Shallow respirations B) Slightly diminished breath sounds C) Decreased wheezing D) Increased crackles E) Increased respiratory rate

A) Shallow respirations C) Decreased wheezing

During a home visit, the nurse observes a family's children acting out, shouting, and hitting each other when taking a small amount of food out of the refrigerator. The mother sits nearby yelling for the children to shut up while reaching for a cigarette. What should the nurse consider as being helpful for this family situation? Select all that apply. A) Suggesting ways to improve the family's financial resources B) Suggesting ways to improve the parent's behavior C) Contacting the authorities because of child abuse D) Making a list of community resources to help this family cope E) Creating a genogram

A) Suggesting ways to improve the family's financial resources B) Suggesting ways to improve the parent's behavior D) Making a list of community resources to help this family cope

a child is brought to the emergency room after he fell and hit his head on the ground. which nursing assessment suggests the child has a concussion? a. sleepy, but easily arousable b. child says he was pushed c. complaining of a stiff neck d. pupils unequal in size

a. sleepy, but easily arousable

The nurse is evaluating care provided to a school-age child recently discharged from the hospital for type 1 diabetes mellitus care. Which observations indicate that care outcomes have been achieved? Select all that apply. A) The client is documenting blood glucose readings and associated insulin dosages in a notebook next to the glucometer. B) The client spends attends school and completes homework before bedtime. C) The client correctly demonstrates drawing up and administering daily insulin dose. D) The client has a glucagon kit in school backpack and explains how it should be used. E) The client watches brothers play Little League baseball on the weekends.

A) The client is documenting blood glucose readings and associated insulin dosages in a notebook next to the glucometer. C) The client correctly demonstrates drawing up and administering daily insulin dose. D) The client has a glucagon kit in school backpack and explains how it should be used.

A client with a bipolar disorder arrives at the Emergency Department disheveled, arguing with family members. The nurse recognizes that the family is suffering from an objective family burden. To what is this burden related? A) The client's symptomatic behaviors B) Family conflict C) Anger D) Caregiving problems

A) The client's symptomatic behaviors

The nurse is caring for a client who is hospitalized with pneumonia. What will the nurse assess when determining the impact of the illness on the family? Select all that apply. A) The duration of the illness B) The effect of the illness on future family functioning C) The cause of the illness D) The meaning of the illness to the family E) The financial impact of the illness

A) The duration of the illness B) The effect of the illness on future family functioning D) The meaning of the illness to the family E) The financial impact of the illness

A nurse is preparing to educate a group of parents on sudden infant death syndrome (SIDS). Which of the following should the nurse include when presenting information on environmental factors that contribute to the occurrence of SIDS? Select all that apply. A) Use of bedding that is firm B) Avoiding overheating the sleeping room C) Avoiding smoking around infants D) Blanket secured lower than chest E) Prone-position sleeping

A) Use of bedding that is firm B) Avoiding overheating the sleeping room C) Avoiding smoking around infants D) Blanket secured lower than chest

The nurse is discussing hospice care with the family of a client dying of cancer. The spouse asks the nurse if Medicare will continue to pay if the client lives longer than 6 months. What should the nurse respond to the spouse? A) "I will call someone in the finance office to come speak with you about your question." B) "Are you concerned about paying for your spouse's health care?" C) "It is unlikely your husband will live past 6 months." D) "Please ask the doctor to explain the role of hospice before discharge."

B) "Are you concerned about paying for your spouse's health care?"

A 2-year-old child with otitis media is prescribed amoxicillin clavulanate 250 mg/5 mL three times daily by mouth for 10 days. What should the nurse teach the mother about this medication? A) "It is ok to stop the antibiotic if the child begins to have side effects." B) "Give the antibiotic for the full 10 days as prescribed." C) "It is important to measure the prescribed dose in a household teaspoon." D) "Be sure to administer a loading dose of the medication when you get home."

B) "Give the antibiotic for the full 10 days as prescribed."

The nurse instructs a client with asthma on bronchodilator therapy. Which statement indicates client understanding? A) "The medication widens the airways because it acts on the parasympathetic nervous system." B) "The medication widens the airways because it stimulates the fight-or-flight response of the nervous system." C) "The medication widens the airways because it decreases the production of histamine that narrows the airways." D) "The medication widens the airways because it decreases the production of mucous that narrows the airways."

B) "The medication widens the airways because it stimulates the fight-or-flight response of the nervous system."

A nurse is teaching environmental control to the parents of a child with asthma. Which statement by the parents indicates effective teaching? A) "We'll be sure to use the fireplace often to keep the house warm in the winter." B) "We will replace the carpet in our child's bedroom with tile." C) "We'll keep the plants in our child's room dusted." D) "We're glad the dog can continue to sleep in our child's room."

B) "We will replace the carpet in our child's bedroom with tile."

A child with respiratory syncytial virus (RSV) bronchiolitis is prescribed intubation to maintain an adequate airway. The nurse will collaborate on the care of this client with: Select all that apply. A) An advanced practice nurse. B) A dietitian. C) The primary care physician. D) A respiratory therapist. E) Anesthesiology.

B) A dietitian. D) A respiratory therapist. E) Anesthesiology.

During a follow-up home visit, the nurse is evaluating the success of a family's ability to use internal resources to cope with the illness of a family member. What does the nurse observe that indicates that internal resources are being accessed? Select all that apply. A) Next-door neighbor helping with family chores B) Effective communication pattern C) Skill in providing care to the ill family member D) Church members stopping by with groceries E) Center for Aging picking up the family member to take to a physician's appointment

B) Effective communication pattern C) Skill in providing care to the ill family member

The nurse is developing a plan of care for a toddler with respiratory syncytial virus (RSV). Which intervention would not be appropriate for this client? A) Offer small, frequent meals. B) Encourage to ambulate frequently. C) Encourage oral intake. D) Monitor intake and output.

B) Encourage to ambulate frequently.

During a home visit, the nurse decides that care interventions are needed to address alcohol and substance abuse by family members. Which intervention(s) should the nurse consider when planning care for this family? Select all that apply. A) Suggest grief counseling. B) Evaluate family members' potential for being a danger to self or others. C) Suggest engaging in educational activities. D) Be alert to behaviors that indicate sibling jealousy. E) Recommend community resources to assist with substance abuse behavior.

B) Evaluate family members' potential for being a danger to self or others. E) Recommend community resources to assist with substance abuse behavior.

The antepartum nurse is caring for parents who have lost their baby at 20 weeks' gestation. Which intervention is most appropriate for the nurse to implement with this family? A) Calling social services to help with burial plans B) Explaining the causative factor of the fetal loss C) Telling the parents they can have another baby D) Obtaining an order for counseling for the parents

B) Explaining the causative factor of the fetal loss

A nurse is caring for a 3-year-old female client who was admitted for dehydration. The child lives with her parents and maternal grandparents. In which type of family does this child reside? A) Blended family B) Extended C) Two-career family D) Traditional family

B) Extended

The Intensive Care nurse is preparing to admit a school-age child for treatment of diabetic ketoacidosis. On what should the nurse focus for this client's care? Select all that apply. A) Peripheral perfusion B) Fluid volume overload C) Frequent blood glucose monitoring D) Intravenous fluid infusions E) Insulin infusion

B) Fluid volume overload C) Frequent blood glucose monitoring D) Intravenous fluid infusions E) Insulin infusion

A multidisciplinary conference has concluded that focused on the care needs of a 10-year-old child with type 2 diabetes mellitus. On which areas should the team focus care to improve this client's long-term prognosis? Select all that apply. A) Weaning off oral medications B) Food intake based on age, sex, and physical activity C) Obtaining adequate rest and sleep D) Physical activity to be at least 30-60 minutes per day most days of the week E) Family participation in the lifestyle change

B) Food intake based on age, sex, and physical activity D) Physical activity to be at least 30-60 minutes per day most days of the week E) Family participation in the lifestyle change

A client with severe right-sided abdominal pain is experiencing a miscarriage. Which nursing diagnosis is most appropriate for this client? A) Anxiety B) Grieving C) Interrupted Family Processes D) Ineffective Coping

B) Grieving

The nurse is creating a plan of care for the family of a client with a terminal illness. What aspects of this family's care should the nurse emphasize when creating this plan? Select all that apply. A) Instructing on medication administration B) Guiding to determine realistic goals C) Identifying strategies to enhance family functioning D) Suggesting that cultural practices be minimized at this time E) Focusing on the client's health needs as a priority

B) Guiding to determine realistic goals C) Identifying strategies to enhance family functioning

The nurse is finalizing a plan of care for a school-age child newly diagnosed with type 1 diabetes mellitus. On which areas should the plan focus to achieve the maximum outcomes for this client? Select all that apply. A) Ways to minimize the number of school days missed B) Identification and referral to community resources C) Physical activities that limit exposure to injuries D) Self-management of glucose monitoring and medications E) Signs and symptoms of hypoglycemia and actions to take

B) Identification and referral to community resources D) Self-management of glucose monitoring and medications E) Signs and symptoms of hypoglycemia and actions to take

The nurse caring for the new mother of African-American descent should implement which intervention regarding sudden infant death syndrome (SIDS)? A) Instruct on side-lying and face-down positions when in the crib. B) Instruct on face-up position when in the crib. C) Ensure adequate nutritional intake for the mother and newborn. D) Encourage good hand washing.

B) Instruct on face-up position when in the crib.

The nurse is planning care for a 6-year-old child newly diagnosed with type 1 diabetes mellitus. The child's mother appears unconcerned with the diagnosis and is complaining about the cost of medication, as three additional children in the family have needs. On which nursing diagnoses should the nurse focus when planning this client's care? Select all that apply. A) Chronic Pain B) Knowledge Deficit C) Ineffective Coping (Family) D) Risk for Unstable Blood Glucose E) Risk for Injury

B) Knowledge Deficit C) Ineffective Coping (Family) D) Risk for Unstable Blood Glucose

The nurse is planning care for a child with respiratory syncytial virus (RSV) bronchiolitis with Impaired Gas Exchange. What should be included in this client's plan of care? Select all that apply. A) Weigh daily. B) Monitor vital signs and pulse oximetry. C) Administer oxygen as prescribed. D) Weigh diapers. E) Provide frequent rest periods.

B) Monitor vital signs and pulse oximetry. C) Administer oxygen as prescribed.

A nurse is caring for a client who just found out she has had a miscarriage. The nurse understands that the client will likely grieve over the loss. What is true regarding perinatal loss grieving? A) The grief experienced by fathers after perinatal loss appears similarly to the grief experienced by mothers after perinatal loss. B) Postpartum depression may occur in women who have experienced perinatal loss. C) Grief is typically less severe when the perinatal loss occurs before 20 weeks' gestation. D) Perinatal loss refers only to emotional changes that occur after perinatal loss.

B) Postpartum depression may occur in women who have experienced perinatal loss.

While attending a community health fair, the nurse observes the children of one family walking quietly behind the father with their mother and periodically shyly asking the father questions. The father responds gruffly and continues walking while the children and mother scurry behind to keep up. What does this observation indicate to the nurse? Select all that apply. A) The father is in a hurry. B) The father is the leader in the family. C) The children are not to bother the father. D) The children need discipline. E) The mother's role is to care for the children.

B) The father is the leader in the family. C) The children are not to bother the father. E) The mother's role is to care for the children.

A new mother asks what needs to be done to prevent the baby from sudden infant death syndrome. What should the nurse do to assist the mother? A) Instruct the mother to keep the baby with her at all times to assess for apnea periods. B) There is no one cause for the syndrome; the best thing is to keep the baby healthy. C) Encourage the mother to place the child in a face-down position for sleep. D) Suggest the mother avoid immunizing the child.

B) There is no one cause for the syndrome; the best thing is to keep the baby healthy.

The nurse is caring for a 40-year-old client who just had amniocentesis and was told that the fetus has Down syndrome. What is an appropriate outcome goal for this client? A) To complete the work of grieving during the hospital stay B) To begin the process of grieving the loss of a normal baby C) To accept the upcoming birth of a baby with special needs D) To consider the possibility of a therapeutic abortion

B) To begin the process of grieving the loss of a normal baby

The nurse is reviewing discharge instructions with a client who is newly diagnosed with asthma. Which statement made by the client indicates a need for further teaching? A) "I need to rinse my mouth after every use of my inhaler." B) "I need to take my Singulair at least 1 hour before I eat." C) "I can resume my ephedra when I return home." D) "Because I am on theophylline, I will need to have therapeutic blood levels drawn."

C) "I can resume my ephedra when I return home."

A client asks why asthma medication is needed even though the client's last attack was several months ago. What would be the best response for the nurse to make to the client? A) "The medication needs to be taken or your lungs will be severely damaged and we will not be able to prevent an acute attack." B) "The medication needs to be taken indefinitely according to your doctor, so you should discuss this with him." C) "The medication is still needed to decrease inflammation in your airways and help prevent an attack." D) "The medication needs to be taken for at least a year; then, if you have not had an acute attack, you can stop it."

C) "The medication is still needed to decrease inflammation in your airways and help prevent an attack."

The nurse is instructing new parents on ways to avoid sudden infant death syndrome with their newborn son. What should be included in these instructions? Select all that apply. A) There is nothing that can be done, so requirements for toys and bedding are of no consequence. B) Instruct that it is more common in babies from ages 6 months to 18 months. C) Avoid placing the baby in the prone or side-lying position for sleep. D) Remind the parents that the syndrome is more common in females than males, and that they have a male child. E) Do not smoke near the child and reduce all exposure to secondhand smoke.

C) Avoid placing the baby in the prone or side-lying position for sleep. E) Do not smoke near the child and reduce all exposure to secondhand smoke.

The nurse determines that care provided to a client with respiratory syncytial virus (RSV) bronchiolitis has been effective when what is assessed? A) Client ingesting small amounts of clear fluids when encouraged B) Client resting in bed with limited interest in play or activities C) Client respiratory rate within normal limits for age D) Client coughing copious amounts of green sputum and requires occasional suctioning.

C) Client respiratory rate within normal limits for age

The nurse is caring for a woman who was involved in a car accident. The client's husband was killed in the accident. The couple has two teenage children. Which statement explains how this tragedy will be approached by the family? A) The family feels that their place in the community has been eliminated. B) Family members may become detached from extended family. C) Family disorganization may occur. D) The family may withdraw into seclusion during the grief process.

C) Family disorganization may occur.

Which assessment findings indicate that a client with asthma needs immediate attention? Select all that apply. A) Retractions and fatigue B) Tachycardia and tachypnea C) Inaudible breath sounds D) Diffuse wheezing and the use of accessory muscles when inhaling E) Reduced wheezing and an ineffective cough

C) Inaudible breath sounds E) Reduced wheezing and an ineffective cough

The nurse walks into an examination room and sees a young child demonstrate a specific behavior (pulling at ear). Which health problem should the nurse suspect the child is experiencing? A) Sore throat B) Hunger C) Otitis media D) Head cold

C) Otitis media

A client has completed the full course of antibiotics prescribed to treat otitis media. Which primary manifestation of the disorder will be relieved as evidence that treatment has been effective? A) Impaired hearing B) Dizziness C) Pain D) Nausea and vomiting

C) Pain

The nurse observes a young child, admitted with possible respiratory syncytial virus (RSV) bronchiolitis, grunting with expiration. What should the nurse do to assist this child? A) Assist the child to clear the nasal passages. B) Limit fluids. C) Suction the airway to relieve the obstruction. D) Lay the child on his back.

C) Suction the airway to relieve the obstruction.

The nurse is planning care for a new mother of African-American descent who smoked during the pregnancy and whose sister lost a child to sudden infant death syndrome (SIDS). What should be included in this client's plan of care? Select all that apply. A) Information on bottle-feeding the infant B) Reasons why the child should sleep with others C) Ages at which the child should receive immunizations D) Using bedding that is firm E) Smoking cessation information

D) Using bedding that is firm E) Smoking cessation information

The nurse is caring for a premature baby who was born at 28 weeks' gestation. The baby's parents tell a visiting family member, "we'll be ready to bring the baby home in a few weeks." Which is the most therapeutic response by the nurse in this situation? A) "A therapist could help you resolve your feelings of denial." B) "I'm glad he's doing so well." C) "Do you have the nursery ready yet?" D) "Although your baby is doing quite well, he probably won't be ready to come home for a few months."

D) "Although your baby is doing quite well, he probably won't be ready to come home for a few months."

The nurse is caring for an adolescent client who has just learned she is pregnant. In order to decrease the risk of perinatal loss with this client, the nurse wants to assess the client for specific risk factors. What information will the nurse want to question specifically for the adolescent who was just informed she is pregnant? A) "Please tell me about your dietary habits." B) "When was your last menstrual period?" C) "Is this your first pregnancy?" D) "Do you use any substances such as drugs, alcohol, or tobacco products?"

D) "Do you use any substances such as drugs, alcohol, or tobacco products?"

Friends of a client hospitalized with asthma would like to bring the client a gift. Which of the following could the nurse suggest as a gift for the client? A) A basket of flowers B) A stuffed animal C) Fruit and candy D) A book

D) A book

Supportive care for the parents of an infant who died from sudden infant death syndrome (SIDS) would include: A) Advising the parents that an autopsy is not necessary. B) Sheltering the parents from their grief by not giving them any personal items of the infant, such as footprints. C) Interviewing the parents to determine the cause of the SIDS incident. D) Allowing the parents to hold, touch, and rock the infant.

D) Allowing the parents to hold, touch, and rock the infant.

During a home visit, the nurse instructs a young mother to bottle-feed the baby in the upright position. Which health problem will this position help prevent from developing in this child? A) Choking B) Aspiration C) Sinus infection D) Otitis media

D) Otitis media

The nurse caring for a client newly diagnosed with asthma is developing the client's plan of care. Which intervention would be most appropriate for the nurse to include in the plan of care if the nurse wants to promote airway clearance? A) Provide adequate rest periods. B) Reduce excessive stimuli. C) Assist with ADLs. D) Place in Fowler position.

D) Place in Fowler position.

A nurse working in labor and delivery is planning care for a client who is arriving to the unit from a local obstetrician's office with a suspected perinatal loss. What nursing implementation is best for this client and the client's family? A) Place the client in a room closest to the nurse's station to closely observe the client. B) Call the hospital chaplain to ensure the chaplain can be in the client's room when the client arrives. C) Call the local funeral home and notify them of the client's situation. D) Place the client in the room furthest from the other clients.

D) Place the client in the room furthest from the other clients.

What makes keeping diabetes in control in an adolescent difficult? (Select all that apply.) a. Hormonal changes b. peer pressure for substance use c. erratic eating problems d. Growth spurts e. adequate knowledge of disease

a. Hormonal changes b. peer pressure for substance use c. erratic eating problems e. adequate knowledge of disease

which description is most appropriate for the family centers care approach? a. a collaborative plan of care is developed to achieve optimal health b. the nursing care is focused on the client as an individual c. the nursing care is based solely on standards of practice d. the healthcare provider is the expert in developing a plan of care

a. a collaborative plan of care is developed to achieve optimal health

a female client is admitted in a disoriented and restless state after sustaining a concussion during a car accident. which assessment data takes highest priority in this client's plan of care? a. acute confusion b. inability to dress self c. unable to complete sentences d. feeling nauseous when eating

a. acute confusion

a client diagnosed with a mild concussion is being discharged from the ED. which discharge instruction should the nurse teach the clients significant other? a. awaken the client every 2 hours b. monitor for increased ICP c. allow the client to sleep, this will help the brain to recover d. offer the client food every 3 to 4 hours

a. awaken the client every 2 hours

a school-age client tells you that "grandpa, mommy, daddy and my brother live at my house." which type of family will the nurse identify in the medical record based on this description? a. extended family b. binuclear family c. gay or lesbian family d. traditional nuclear family

a. extended family

the nurse has completed a family assessment and is planning care for a newly blended family. the children are having trouble adapting to the new situation. what is the primary goal for this family? a. improve family situations b. practice life skills c. work with other families d. self-evaluate

a. improve family situations

a nurse is caring for two pediatric clients newly diagnosed with diabetes. one client has type 1 diabetes and the other client has type 2 diabetes. When discussing the difference between type 1 and type 2 diabetes, the nurse recognizes what clinical presentation about type 1? a. the diagnosis is often made following an acute onset of keto acidosis b. onset of the disease is slow c. excessive weight is a contributing factor d. treatment involves diet, exercise, and oral medication

a. the diagnosis is often made following an acute onset of keto acidosis

the nurse is caring for a client who is hospitalized with pneumonia. which will the nurse assess when determining the impact of the illness on the family? SATA a. the duration of the illness b. the effect of the illness on future family functioning c. the cause of the illness - bacterial or viral d. the meaning of the illness to the family e. the financial impact of the illness

a. the duration of the illness b. the effect of the illness on future family functioning d. the meaning of the illness to the family e. the financial impact of the illness

which clients should the nurse identify as being at risk for perinatal loss? SATA a. the woman recovering from a gastrointestinal virus b. the woman who lacks access to health and prenatal care c. the woman who had a healthy baby 6 months ago resulting from a healthy pregnancy d. the unmarried 14-year-old girl living in the city e. the woman who drinks one cup of coffee every morning

a. the woman recovering from a gastrointestinal virus b. the woman who lacks access to health and prenatal care d. the unmarried 14-year-old girl living in the city

a community health nurse is planning a safety session for children and their parents. the focus will be on concussion prevention. which should be included? SATA a. wear a safety helmet when riding a bike b. teach children to avoid stairs c. have a soft surface like mulch below swing sets d. avoid tripping hazards in the home

a. wear a safety helmet when riding a bike c. have a soft surface like mulch below swing sets d. avoid tripping hazards in the home

the nurse is assigned to care for a child in a spica cast for fractured femur suffered in an automobile accident. The child's father was driving the family, The nurse learns that the father just recently lost his job and the mother has been working through a "temp" agency. Which nursing diagnosis fits the family? a. caregiver role strain related to a child with a disability and the associated financial burden b. compromised family coping related to the effects of multiple simultaneous stressors c. interrupted family processes related to child with a significant disability requiring alteration in family functioning d. impaired social interaction (parent and child) related to the lack of family or respite support

b. compromised family coping related to the effects of multiple simultaneous stressors

a nurse is caring for a preschool age client who was admitted for dehydration. the child lives with the parents and maternal grandparents. in which type of family does this child reside? a. blended b. extended c. two-career d. traditional

b. extended

a nursing is caring for a 2-year-old child who has had 3 ear infections in the past 5 months. the nurse should know that the child is at risk for developing which of the following as a long-term complication? SATA a. perforation of the tympanic membrane b. prolonged hearing loss c. speech delays d. mastoiditis

b. prolonged hearing loss c. speech delays

the pediatric nurse is providing education to a new mother regarding ways to decrease the risk of SIDS. which statement by the nurse is appropriate? a. you should keep the baby with you at all times to assess for apnea b. there is no one cause for the syndrome; the best thing is to understand the risks and eliminate them c. it is recommended that you place your baby in a face-down position for sleep d. SIDS has been linked to immunizations. i recommend that you avoid immunizing your baby

b. there is no one cause for the syndrome; the best thing is to understand the risks and eliminate them

the nurse is observing a family counseling session that is focusing on the family members' communication patterns. which observation indicates that there are existing or potential problems with family communication? a. all members are participating in the discussion equally b. a few of the members just sit and listen c. disagreements are ignored by the family leader d. the verbal communication is congruent with nonverbal messages

c. disagreements are ignored by the family leader

a primigravida is hospitalized at 32 weeks' gestation after a second hemorrhage from a complete placenta previa. the client delivers a stillborn infant 1 week later. which intervention should the nurse perform to help this family in the grieving process? a. remove all baby supplies from the mother's room b. refrain from talking about the baby c. facilitate and support the family viewing and holding the infant d. ask to have the mother moved off the postpartum floor

c. facilitate and support the family viewing and holding the infant

the nurse is evaluating care provided to a new mother regarding infant risk for sudden death syndrome. which statement by the mother indicates teaching has been effective? a. i will place my baby in a side-lying position for sleep b. i need to purchase loose-fitting sheets and blankets for the bed c. i plan to quit smoking and will not smoke around baby until then d. i will bottle-feed my baby since breastfeeding is a risk factor for SIDS

c. i plan to quit smoking and will not smoke around baby until then

a 15-year-old adolescent is found to have type 1 diabetes. what should the nurse include when teaching the adolescent about type 1 diabetes? a. it occurs more often in obese adolescents b. it does not always require insulin c. it involves early vascular changes d. it has a more rapid onset than type 2 diabetes

c. it involves early vascular changes

following the diagnosis of concussion, the nurse is preparing to discharge the client from the ED. which is not appropriate for discharge education? a. allow the client to rest as much as needed b. returning to sports should wait until recovery c. severe migraines are normal during recovery d. avoiding alcohol is important

c. severe migraines are normal during recovery

a nurse explains to the mother of a 1-year-old with a history of frequent ear infections that the PRIMARY cause of otitis media in young children is what? a. recurrent tonsillitis b. an inflamed mastoid process c. sinusitis d. an obstructed eustachian tube

d. an obstructed eustachian tube