Question

A nurse is caring for a 4-year-old child who is resistant to taking medication. Which of the following strategies should the nurse use to elicit the child’s cooperation?

Answer 1

Correct Answers:

Offer the child a choice of taking the medication with juice or water

Rationale :

Allowing a child to choose how they take their medication gives them a sense of control, reducing resistance. It also helps build trust between the nurse and the child, improving compliance. Forcing medication or misleading the child can create anxiety and fear of medical procedures.

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Answer 2

Correct Answers:

Elevated ST segment
Abnormally prominent U wave

Rationale :

Hypokalemia affects cardiac conduction, leading to characteristic ECG changes, including prominent U waves, flattened T waves, and ST depression. These changes indicate delayed ventricular repolarization, which can result in life-threatening arrhythmias. Early recognition and potassium replacement are crucial.

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Answer 3

Correct Answers:

Median vein in the forearm

Rationale :

The median vein in the forearm is a stable and less fragile site for IV insertion, especially in older adults with delicate veins. Using veins in the wrist or hand increases the risk of complications like infiltration, phlebitis, and discomfort. Choosing a larger, more stable vein ensures better IV therapy success.

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Answer 4

Correct Answers:

"Crushing the medication would release all the medication at once, rather than over time.

Rationale :

Enteric-coated medications are designed to bypass stomach acid and dissolve in the intestines. Crushing them destroys this protective coating, leading to irritation, increased side effects, and reduced drug efficacy. Alternative formulations should be considered for clients with swallowing difficulties.

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Answer 5

Correct Answers:

"l have to choose a family member as my health proxy.•

Rationale :

A healthcare proxy can be any competent adult, not necessarily a family member. The client has the right to choose someone they trust to make medical decisions on their behalf if they become incapacitated. This decision should be based on the individual’s ability to respect the client's wishes, not family obligation.

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Answer 6

Correct Answers:

Renew the events lead up to each medication administration error

Rationale :

Understanding the root causes of medication errors is essential for preventing future incidents. Identifying factors like miscommunication, workflow inefficiencies, or distractions allows for targeted interventions. Implementing systemic improvements rather than solely focusing on individual performance enhances patient safety.

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Answer 7

Correct Answers:

Red colored urine

Rationale :

Rifampin commonly causes harmless discoloration of bodily fluids, including red or orange urine, sweat, saliva, and tears. This side effect should be communicated to clients to prevent alarm. It does not indicate bleeding or drug toxicity.

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Answer 8

Correct Answers:

Do not palpate abdomen

Rationale :

Wilms tumor is a kidney malignancy that can rupture if palpated, leading to tumor spread. A sign should be placed above the child's bed to prevent unnecessary abdominal examination by staff or family. This precaution helps reduce the risk of metastasis.

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Answer 9

Correct Answers:

Monitor the client for at least 3 hr after the injection.

Rationale :

Olanzapine IM has a risk of post-injection delirium/sedation syndrome, requiring monitoring for at least 3 hours. This ensures early detection of adverse reactions like dizziness, sedation, or hypotension. Keeping the client under observation ensures safety.

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Answer 10

Correct Answers:

"It occurs during the first trimester and near the end of the pregnancy."

Rationale :

Increased urinary frequency occurs in early pregnancy due to hormonal changes and increased blood flow to the kidneys. It returns in the third trimester when the enlarging uterus puts pressure on the bladder. Clients should be reassured that this is normal.

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RN Medsurg Nurs 4650 Comprehensive Exam

No.

1 : A nurse is caring for a 4-year-old child who is resistant to taking medication. Which of the following strategies should the nurse use to elicit the child’s cooperation?

2 : A nurse is reviewing the EKG strip of a client who has prolonged vomiting. Which of the following abnormalities on the client’s EKG should the nurse interpret as a sign of hypokalemia?

3 : A nurse is inserting an IV catheter for an older client in preparation for an outpatient procedure. Which of the following veins should the nurse select?

4 : A nurse is caring for a client who has difficulty swallowing medications and is prescribed enteric-coated aspirin PO once daily. The client asks if the medication can be crushed to make it easier to swallow. Which of the following responses should the nurse provide?

5 : A nurse is caring for a client who has named a person to serve as his health care proxy. The client talks about this type of advance directive. Which of the following statements by the client indicates a need for clarification?

6 : A nurse is serving on a continuous quality improvement (CQI) committee that has been assigned to develop a program to reduce the number of medication administration errors following a sentinel event at the facility. Which of the following strategies should the committee plan to initiate first?

7 : A nurse is caring for a client who has active pulmonary tuberculosis (TB) and a new prescription for IV rifampin. The nurse should instruct the client that they should expect to experience which of the following manifestations while taking this medication?

8 : A child is admitted with a suspected diagnosis of Wilms tumor. The nurse should place a sign with which of the following warnings over the child's bed?

9 : A nurse is planning to administer olanzapine 10 mg 1M to a client who has schizophrenia. Which of the following actions should the nurse take?

10 : A nurse in a prenatal clinic is caring for a client who is at 7 weeks of gestation. The client reports urinary frequency and asks if this will continue until delivery. Which of the following responses should the nurse make?

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