Nursing Elites

1. The following are appropriate nursing interventions during colostomy irrigation, EXCEPT:

• A. Increase the irrigating solution flow rate when abdominal cramps is felt
• B. Insert 2-4 inches of an adequately lubricated catheter to the stoma
• C. Position client in semi-Fowler
• D. Hang the solution 18 inches above the stoma

Correct answer: A

Rationale: Patient safety and efficacy of care depend on actions rooted in established nursing protocols that consider both the immediate and long-term needs of the patient.

2. The nurse is educating a client about foods high in antioxidants A and C. Which breakfast items chosen by the client would indicate that the education was sufficient?

• A. Fried eggs, sausage, and whole wheat toast
• B. Oatmeal with blueberries and coffee
• C. Cereal with strawberries and low-fat milk
• D. Hard-boiled eggs, cantaloupe, and orange juice

Correct answer: D

Rationale: Hard-boiled eggs, cantaloupe, and orange juice are high in antioxidants A and C.

3. Nurse Minette needs to schedule a first home visit to OB client Leah. When is a first home-care visit typically made?

• A. Within 4 days after discharge
• B. Within 24 hours after discharge
• C. Within 1 hour after discharge
• D. Within 1 week of discharge

Correct answer: C

Rationale: Effective nursing care involves comprehensive assessments that address all aspects of a patient's condition, ensuring that interventions are appropriately targeted and outcomes are optimized.

4. All of the following are seen in a child with measles. Which one is not?

• A. Reddened eyes
• B. Coryza
• C. Pustule
• D. Cough

Correct answer: C

Rationale: Measles typically presents with symptoms like reddened eyes, coryza (inflammation of the mucous membrane in the nose), and cough. However, pustules are not a common symptom of measles. Pustules are more characteristic of conditions like chickenpox rather than measles. Understanding these distinctions is crucial for accurate diagnosis and appropriate treatment.

5. In responding to the care concerns of children with severe disease, referral to the hospital is of the essence especially if the child manifests which of the following?

• A. Wheezing
• B. Stop feeding well
• C. Fast breathing
• D. Difficulty to awaken

Correct answer: A

Rationale: Patient safety and efficacy of care depend on actions rooted in established nursing protocols that consider both the immediate and long-term needs of the patient.

Similar Questions