NU471 Week 4 EAQ #3 Evolve Elsevier: Safety - Mastery Level Target: Level 3

Which parental statement would the nurse recognize as indicating a need for further education about infant drowning prevention? o "I have signed my infant up for swimming lessons." o "My infant is never left alone in the water." o "I make sure I am at the poolside when my infant is in his or her floating device." o "Even though my child is still an infant, I still lock the gate to the swimming pool."

o "I make sure I am at the poolside when my infant is in his or her floating device." · An infant should never be more than an arm's length away at all times when swimming in the pool. Swimming lessons are encouraged. Infants should never be left alone in the water, because they can drown in as little as 2 inches of water. The gate to the swimming pool should be locked at all times when the pool is not being used, and the latch should be up high, out of reach for small children.

Which parental statement would concern the nurse during a toddler's wellness visit? o "My child loves to eat popcorn." o "My child loves our family pets." o "My child likes to play with gardening toys." o "My child loves to play with a fork and spoon."

o "My child loves to eat popcorn." · Popcorn kernels pose a choking risk to a toddler. The statement about the child who loves the family pet does not indicate there is any risk of injury. There is no risk of injury if a toddler has age-appropriate gardening toys. The statement about the child playing with a fork and spoon does not pose a danger unless the child is ambulating with utensils.

When a client with a prosthetic heart valve asks the nurse why it is important to take antibiotics before a dental procedure, which response by the nurse is accurate? o "The antibiotic is taken to prevent infection around your artificial heart valve." o "Valvular heart disease increases the risk for dental caries and gum disease." o "All clients with murmurs need prophylactic antibiotics before dental procedures." o "You only need to take the antibiotic if you have a fever before your dental procedure."

o "The antibiotic is taken to prevent infection around your artificial heart valve." · An antibiotic is taken prophylactically to prevent infection of the heart if bacteria from the mouth enter the bloodstream. The risk for valvular heart disease (e.g., endocarditis) after invasive dental procedures is increased in clients with artificial heart valves, but the risk for dental infections such as caries or inflammatory gum disease is not increased by artificial heart valves. Current recommendations are that clients with artificial heart valves, a history of endocarditis, or uncorrected congenital heart disease should receive prophylactic antibiotics, but most clients with murmurs do not need antibiotic prophylaxis before invasive procedures. The prophylactic antibiotics should be taken as prescribed before the dental procedure to prevent endocarditis. If the client experiences fever, it should be reported to the dentist and health care provider and may require further evaluation and treatment.

Which school-age developmental characteristics increases the child's s risk for poisoning? Select all that apply. o Trying new things o Adhering to group rules o Increasing independence o Being easily influenced by peers o Having a strong allegiance to friends

o Adhering to group rules o Being easily influenced by peers o Having a strong allegiance to friends · Developmental characteristics of the school-age client that increase the risk for poisoning include adhering to group rule, being easily influenced by peers, and having a strong allegiance to friends. Trying new things and increasing independence increase the risk for burn injury, not the risk for poisoning.

The nurse is admitting a client with severe myxedema coma. Which interventions would the nurse include in the plan of care? Select all that apply. o Administer intravenous (IV) levothyroxine. o Avoid use of corticosteroids. o Give IV normal saline. o Wait for laboratory results before treating. o Monitor blood pressure every 4 hours.

o Administer intravenous (IV) levothyroxine. o Give IV normal saline. · Myxedema coma is a major complication of poorly treated hypothyroidism. Interventions include administering IV levothyroxine. This promotes the return to normal thyroid hormone levels. IV normal saline corrects dehydration. Corticosteroids are administered as part of the treatment. Levothyroxine is initiated before obtaining laboratory results because waiting can cause death. The blood pressure should be monitored hourly.

Which information would the nurse provide a client beginning treatment with haloperidol to prevent injury? o Monitor temperature. o Wear a mask when out. o Change positions slowly. o Report pacing and squirming.

o Change positions slowly. · Antipsychotic medications can cause orthostatic hypotension through their mechanism of action—blocking alpha1-adrenergic receptors in blood vessels. To prevent injury, the nurse will instruct clients to change positions slowly to help prevent light-headedness and subsequent injury from falls. Temperature would be monitored with neuroleptic malignant syndrome. Agranulocytosis can occur with certain antipsychotics and increases the risk of infection. Pacing and squirming, or akathisia, can be disturbing for clients but does not place them at risk for injury.

Which finding would lead the nurse to contact the state bureau of motor vehicles to obtain a driving evaluation for an older adult? o Cancer o Arthritis o Dementia o Depression

o Dementia · A client with cognitive deficits such as dementia may lead the nurse to contact the state bureau of motor vehicles. Confusion that accompanies dementia could place the client and others at risk if the client were driving. Cancer, arthritis, and depression do not normally lead to driving impairment.

When preparing to assess a client with active tuberculosis, which piece of protective equipment is necessary for the nurse before entering the client room? o Isolation gown o Surgical mask o Shoe covers o N95 respiratory mask

o N95 respiratory mask · Active tuberculosis places a client on airborne precautions where the nurse must wear an N95 respiratory mask to prevent personal respiratory exposure to the infectious droplets. An isolation gown, surgical mask, or shoe covers are not necessary protective devices in the assessment of a client with active tuberculosis.

The nurse is educating a client on the use of heat and cold for osteoarthritis (OA) pain. Which action by the client indicates the need for additional teaching? o Places ice pack on skin o Uses ice pack for 20 minutes o Applies lightweight heating pad o Tests water before getting into shower

o Places ice pack on skin · When using hot and cold packs, clients will be instructed to avoid placing ice packs directly on the skin because it can cause damage. To prevent skin injury, clients will be instructed to use ice packs for 20-minute intervals, apply a lightweight heating pad, and test the water temperature before getting into the shower.

Offspring of men of advanced paternal age are at an increased risk for which condition? o Schizophrenia o Cystic fibrosis o Sickle cell anemia o Tay-Sachs disease

o Schizophrenia · Advanced paternal age increases the risks of some autosomal dominant disorders, autism spectrum disorder, and schizophrenia. Cystic fibrosis, sickle cell anemia, and Tay-Sachs disease are recessive diseases, and the risk of these diseases does not increase because of advanced paternal age.

Which items would the nurse instruct community members to include in a personal preparedness bag? Select all that apply. o Toiletries o Laptop computer o Cell phone and charger o 3-day supply of clothing o 3-day supply of nonperishable food items

o Toiletries o Cell phone and charger o 3-day supply of clothing o 3-day supply of nonperishable food items · Items that should be included in a person preparedness go bag include toiletries, cell phone and charger, and a 3-day supply of clothing and nonperishable food items. Although a laptop computer may be desired it is unlikely that this item can be stored in a location for potential use. Also, the chances that this device would be helpful during a disaster will depend upon a power source and access to the Internet.

Which clinical finding would prompt the nurse to withhold an allergy hyposensitization injection? o Serous otitis media o Allergic conjunctivitis o Wheezing and dyspnea o Rash on the face and neck

o Wheezing and dyspnea · The introduction of an additional allergen may increase the severity of the child's respiratory distress and cause a life-threatening reaction. Serous otitis media is a common chronic problem among children; it is insufficient justification for withholding the injection. Conjunctivitis is a sign of an allergic response; the injection should be given as long as respiratory problems are not present. A rash on the face and neck is a sign of an allergic response; the injection should be given as long as respiratory problems are not present.