Question 1

A nurse confers with the nutritionist about the diet of a child with decreased mobility due to a fracture. In addition to being non-constipating, the diet should be:

Accepted Answer

In addition to being non-constipating, the diet should be adequate in calories and calcium. Adequate calories support the growth and energy needs of the child, though intake should not exceed energy expenditure. In general, immobility results in deminenarilization. Extra calcium is not needed because it contributes to increased calcium levels in the blood.

Question 2

A baby returns to the unit after a cardiac catheterization. Two hours later, during the change of shifts, the statement about the child's progress that should be questioned by the incoming nurse is that the child:

Accepted Answer

Two hours later, during the change of shifts, the statement about the child's progress that should be questioned by the incoming nurse is that the child is on bed rest with bathroom privileges. The patient is kept on bed rest without bathroom privileges to reduce the risk of bleeding or trauma to the insertion site.

Question 3

Dana is a nurse supervisor at the neonatal intensive care unit. She is reviewing different theories of leadership and management and she came across a theory that states that the effectiveness of leadership is dependent upon the unit's situation. Which of the following leadership styles best fits a situation where the followers are self-directed, experts, and are matured individuals?

Accepted Answer

A leadership style that best fits a situation where the followers are self-directed, experts, and are matured individuals is laissez faire. Laissez faire leadership is preferred when the followers know what to do and are experts in their field. This leadership style is relationship-oriented rather than task-centered.

Question 4

An infant was placed in a spica cast for developmental dysplasia of the hip. To employ immediate care, the nurse plans to report to the physician if the patient has developed:

Accepted Answer

To employ immediate care, the nurse plans to report to the physician if the patient has developed numbness. Numbness is a neurologic symptom that should be reported immediately because it indicates pressure on the nerve and blood vessels.

Question 5

A young patient who is a mother for the first time is very anxious about her new role as a parent. With the nurse's encouragement, she has joined a new mother's support group at the local "X." This part of the plan is an example of:

Accepted Answer

This part of the plan is an example of primary prevention. Primary prevention is directed toward health promotion and prevention of problems.

Question 6

A clinical nurse specialist is planning a discharge conference with a patient's parents and other immediate family members. The priority nursing action that should be included in the discharge plan is:

Accepted Answer

The priority nursing action that should be included in the discharge plan is exploring what has been learned from this hospitalization. Evaluation is the focus of a discharge planning conference; it is most important for the nurse to assist the family in viewing the hospitalization as a learning experience.

Question 7

A nurse tells the parents of an infant with an infected wound that a nurse epidemiologist will visit daily. The parents ask what a nurse epidemiologist does. The nurse could correctly explain the role by saying, "The nurse epidemiologist…"

Accepted Answer

The nurse could correctly explain the role by saying, "The nurse epidemiologist helps providers of care to control infection." A nurse epidemiologist acts as a consultant to help devise an infection control strategy.

Question 8

A cardiac monitor indicates that a patient's heart rate has increased to 160 beats per minute. Shortly after this increase, the nurse notices that the patient is in ventricular tachycardia. The nurse reports this finding to the physician because she knows that an order of which of the following is needed?

Accepted Answer

The nurse reports this finding to the physician because she knows that an order of a bolus of lidocaine is needed. Lidocaine will interrupt VT before it progresses to ventricular fibrillation.

Question 9

A nurse is caring for a newborn patient in the neonatal intensive care unit. She notified the physician because she was able to assess a:

Accepted Answer

She notified the physician because she was able to assess a breathing pattern that is diaphragmatic with sternal retractions. The assessment result is indicative of respiratory distress; the expected pattern is abdominal with synchronous chest movement.

Question 10

A nurse who has been named in a lawsuit can use which of these factors for the best protection in a court of law?

Accepted Answer

A nurse who has been named in a lawsuit can use documentation on the specific patient's record with a focus on the nursing process for the best protection in a court of law. Documentation is the key to protect nurses when a lawsuit is filed. Thorough documentation should include all steps of the nursing process: assessment, analysis, plan, intervention, and evaluation. In addition, it should include pertinent data such as times, dosages and sites of actions, assessment data, the nurse's response to a change in the patient's condition, specific actions taken, if and when the notification occurred to the provider or other health care team members, and what was prescribed, along with the patient's outcomes.

Question 11

A patient's mother asks the nurse about a case manager, specifically the role of a case manager. The nurse should explain that the case manager:

Accepted Answer

The nurse should explain that the case manager coordinates both inpatient and outpatient hospitalization and home care. They plan, coordinate, and monitor services to meet the needs of the patient. They pull together available resources to provide the patient with the best help.

Question 12

A nurse is caring for a patient who is not eating or caring and has refused to leave the house since the death of her infant a year ago. The nurse should give priority to the nursing diagnosis of:

Accepted Answer

The nurse should give priority to the nursing diagnosis of dysfunctional grieving related to loss. The diagnosis includes the presenting symptoms of isolation, self-neglect, and social withdrawal.

Question 13

The parents of a six-month-old patient admitted with diarrhea are anxious and concerned. To involve the parents in the child's care, the nurse should first:

Accepted Answer

To involve the parents in the child's care, the nurse should first teach the parents how to adhere to standard precautions. This technique will allow the parents to learn the proper techniques necessary to prevent the spread of infection and allow them to care for their infant without infecting themselves and others.

Question 14

Before returning a child who is being treated for tuberculosis to his home, the nurse consulted a community health nurse to determine:

Accepted Answer

Before returning a child who is being treated for tuberculosis to his home, the nurse consulted a community health nurse to determine that all family members have been tested. People who have repeated close contact with an infected person who has not been diagnosed are more likely to become infected. Everyone that the patient has had contact with should be assessed with the tuberculin skin test.

Question 15

A patient is prescribed with chlorpropamide (Diabinese). The nurse should notify the physician if the patient reports being allergic to:

Accepted Answer

The nurse should notify the physician if the patient reports being allergic to sulfur. The drug is a sulfonamide, a sulfur-based drug used to treat type diabetes. It would be contraindicated in a patient with an allergy to sulfur.

Question 16

A nurse finds her patient crying because the physician has stated that the patient cannot return home alone and she does not have family nearby. After discussing the patient's concerns, the nurse should contact which of the following:

Accepted Answer

After discussing the patient's concerns, the nurse should contact a case manager. A case manager follows the patient through the entire health care system and back into the community.

Question 17

A nurse calls a physician regarding an order to administer digoxin (Lanoxin) to a patient with pulse of 58 and a serum potassium level of 2.9mEq/L. The physician says to administer the medication as ordered. The nurse should best respond by stating:

Accepted Answer

The nurse should best respond by stating "I will not give the medication." A pulse below 90 in an infant patient is an indication to withhold the drug. Digitalis toxicity can develop in patients with hypokalemia. The nurse should document both findings and not administer the digoxin.

Question 18

A patient is scheduled for an intravenous pyelogram (IVP). After the contrast material is injected, which of the following patient reactions should be reported immediately to the physician?

Accepted Answer

A patient reaction that should be reported immediately to the physician is hives. This is a sign of anaphylaxis and should be reported immediately. The other reactions are considered normal and the patient or family should be informed that they may occur.

Question 19

A nurse in a newborn nursery is monitoring a preterm newborn infant for respiratory distress syndrome. Which assessment signs, if noted in the newborn infant, would alert the nurse to notify the physician to the possibility of this syndrome?

Accepted Answer

Tachypnea and retractions are assessment signs which, if noted in a newborn infant, would alert the nurse to notify the physician and to the possibility of this syndrome. A newborn infant with respiratory distress syndrome may present with clinical signs of cyanosis, tachypnea or apnea, nasal flaring, chest wall retractions, or audible grunts. Acrocyanosis is the bluish discoloration of the hands and feet, is associated with immature peripheral circulation, and is not uncommon in the first few hours of life.

Question 20

A patient in labor, who is at term, is admitted to the birthing room. Her membranes rupture spontaneously. The physician should be notified as soon as possible if the nurse notes:

Accepted Answer

The physician should be notified as soon as possible if the nurse notes greenish fluid. This indicates the presence of meconium and is considered a sign that the fetus is compromised.

Quiz 2: Neonatal