The Correct Answer is Option B

Explanation

A. Take at bedtime

B. Take the medication with juice

C. Report changes in appetite

D. Avoid sunshine while taking the medication

Lugol’s solution is a soluble solution of potassium iodine and should be given with juice because it is bitter to taste. In answer A the medication can be taken at another time, so it is incorrect. Reporting changes in appetite is unnecessary, so answer C is incorrect. Answer D is incorrect because it is also unnecessary.

The Correct Answer is Option C

Explanation

A. Negligence

B. Tort

C. Assault

D. Malpractice

Assault is defined as striking or touching the client inappropriately. Negligence is failing to perform care for the client, so answer A is incorrect. A tort is a wrongful act committed on the client or his belongings, so answer B is incorrect. Malpractice is failing to perform an act that the nurse knows should be done or doing something wrong that causes harm to the client, so answer D is incorrect.

The Correct Answer is Option B

Explanation

A. Surgical ANTT

B. Standard ANTT

C. Sterile ANTT

D. Clean procedure

Simple procedures requiring asepsis will require Standard ANTT. These procedures include simple wound dressings, IV medication preparation and administration, removal of surgical drains, and changing of IV fluids.

Surgical ANTT is for invasive procedures such as IV cannulation and Urinary catheterization

Clean procedures are for non-invasive, non-sterile skills such as NGT insertion or colostomy care.

The Correct Answer is Option A

Explanation

A. Rebound tenderness

B. Rovsing’s sign

C. Turner’s sign

D. Ascites

 Rebound tenderness indicates peritoneal irritation. The client experiences increased pain when the examiner releases pressure in a positive result of this assessment technique. Answers B and C are exhibited by other assessment measures, so they are incorrect. Answer D is a condition of excessive peritoneal fluid in the abdominal cavity associated with liver disorders.

The Correct Answer is Option C

Explanation

A. The client rigidly extends the arms with pronated forearms and plantar flexion of the feet

B. The client flexes a leg at the hip and knee and reports pain in the vertebral column when the leg is extended

C. The client passively flexes the hip and knee in response to neck flexion and reports pain in the vertebral column.

D. The client’s upper arms are flexed and held tightly to the sides of the body and the legs are extended and internally rotated.

Brudzinski’s sign is tested with the client in the supine position. The nurse flexes the client’s head (gently moves the head to the chest), and there should be no reports of pain or resistance to the neck flexion. A positive Brudzinski’s sign is observed if the client passively flexes the hip and knee in response to neck flexion and reports pain in the vertebral column. Kernig’s sign also tests for meningeal irritation and is positive when the client flexes the legs at the hip and knee and complains of pain along the vertebral column when the leg is extended. Decorticate posturing is abnormal flexion and is noted when the client’s upper arms are flexed and held tightly to the sides of the body and the legs are extended and internally rotated. Decerebrate posturing is abnormal extension and occurs when the arms are fully extended, forearms pronated, wrists and fingers flexed, jaws clenched, neck extended, and feet plantar-flexed

The Correct Answer is Option A

Explanation

A. Warming the intravenous fluids

B. Determining whether the client can take oral fluids

C. Checking for the strength of pedal pulses

D. Obtaining the specific gravity of the urine

Warming the intravenous fluid helps to prevent further stress on the vascular system. Thirst is a sign of hypovolemia; however, oral fluids alone will not meet the fluid needs of the client in hypovolemic shock, so answer B is incorrect. Answers C and D are wrong because they can be used for baseline information but will not help stabilize the client.

The Correct Answer is Option B

Explanation

A. The nurse offers extra blankets.

B. The nurse places a tracheostomy tube at the bedside.

C. The nurse insists that the client refrain from talking.

D. The nurse administers pain medication every four hours.

The thyroid is located anterior to the trachea; therefore, laryngeal stridor and airway obstruction is a risk following a thyroidectomy. Answer A is incorrect because this action is not necessary. The need for extra blankets is associated with hypothyroidism, but is not directly associated with thyroid surgery. Answer C is incorrect because the client can talk. Answer D is incorrect because pain medication should be offered as needed, not every four hours.

The Correct Answer is Option A

Explanation

A. A 42-year-old with dyspnoea and chest asymmetry

B. A 17-year-old with a fractured arm

C. A 4-year-old with facial lacerations

D. A 30-year-old with blunt abdominal trauma

Following the ABCDs of basic emergency care, the client with dyspnea and asymmetrical chest should be cared for first because these symptoms are associated with flail chest. Answer D is incorrect because he should be cared for second because of the likelihood of organ damage and bleeding. Answer B is incorrect because he should be cared for after the client with abdominal trauma. Answer C is incorrect because he should receive care last because his injuries are less severe.

The Correct Answer is Option B

Explanation

A. Urinary output

B. Respirations

C. Temperature

D. Verbal responsiveness

Answer B is correct. Barbiturate overdose results in central nervous system depression, which leads to respiratory failure. Answers A and C are important to the client’s overall condition but are not specific to the question, so they are incorrect. The use of barbiturates results in slow, slurred speech, so answer D is expected, and therefore incorrect.

The Correct Answer is Option B

Explanation

A. 2–4 mm

B.  3–5 mm

C. 6–8 mm

D. 7–9 mm

The normal pupil diameter is between 3 and 5 mm in size. Answers A, C, and D are not normal pupil diameters; therefore, they are incorrect.

The Correct Answer is Option C

Explanation

Partial seizures usually originate in the temporal lobe, making Answers A, B, and D incorrect because partial seizures do not usually occur in the other lobes.

The Correct Answer is Option C

Explanation

A. Take the medication as ordered prior to the exam

B. Limit the amount of protein in the diet prior to the exam

C. Discontinue the medication prior to the exam

D. Take the medication with only water prior to the exam

Glucophage can cause renal problems. The dye used in cardiac catheterizations is also detrimental to the kidneys. The client may be placed on sliding scale insulin for 48 hours after the dye procedure or until renal function returns. Note the syllable phage, as seen in the syllable phagia, which means eating. Also note that answers A and C are opposites. Answer A is incorrect because the medication should be withheld; answer B is incorrect because limiting the amount of protein in the diet prior to the exam has no correlation to the medication. Taking the medication with water is not necessary, so answer D is incorrect.

The Correct Answer is Option C

Explanation

A. Take the medication before arising

B. Force fluids while taking this medication

C. Remain upright for 30 minutes after taking this medication

D. Take the medication in conjunction with estrogen

Alendronate sodium is a drug used to treat osteoporosis. Let’s use testing strategies for this question. Look at answers A and C; these are opposites. When you are in the bed, you are lying down. The drug should not be given while lying down, nor should it be taken with medication or with estrogen. In answer C, you are upright. This drug causes gastric reflux, so you should remain upright and take it with only water. Notice the clue in the name of the drug: fosa, as in fossils. All the drugs in this category contain the syllable dronate.

The Correct Answer is Option A

Explanation

A. Chloride level

B. Potassium transport

C. Serum sodium

D. Calcium level

A positive sweat test is reflected by elevations in the chloride level. Answers B, C, and D are not measured by the sweat test; therefore, they are incorrect.

The Correct Answer is Option C

Explanation

A. Call for help.

B. Extinguish the fire.

C. Activate the fire alarm.

D. Confine the fire by closing the room door.

The order of priority in the event of a fire is to rescue the clients who are in immediate danger. The next step is to activate the fire alarm. The fire then is confined by closing all doors and, finally, the fire is extinguished.

The Correct Answer is Option B

Explanation

A. Place a tourniquet proximal to the laceration

B. Elevate the leg above the level of the heart

C. Cover the laceration and apply an ice compress

D. Apply pressure to the femoral artery

If bleeding does not subside with direct pressure, the nurse should elevate the extremity above the level of the heart. Answers A and D are done only if other measures are ineffective, so they are incorrect. Answer C would slow the bleeding, but will not stop it, so it’s incorrect.

The Correct Answer is Option C

Explanation

A. Syndenham’s chorea

B.  Polymigratory arthritis

C. Splinter hemorrhages

D. Erythema marginatum

Splinter hemorrhages, dark lines beneath the nails, are associated with embolization. Answers A, B, and D are associated with rheumatic fever, not infective bacterial endocarditis; therefore, they are incorrect.

The Correct Answer is Option D

Explanation

A. 1400

B. 1500

C. 1600

D. 1700

Blood must be finished within four hours of the start time. Answers in A, B, and C are before the 4-hour time limit, so they are incorrect.

The Correct Answer is Option D

Explanation

Use the medication formula:

Desired / Available x Volume = 1,000,000units / 1,200,000units x 2mL = 1.66666666667 mL

Rounded off to two decimal places: 1.67 mL

The Correct Answer is Option B

Explanation

A. Administering a local anesthetic

B. Checking for an allergic response

C. Administering an anxiolytic

D. Withholding fluids for 6–8 hours

The nurse should perform the skin or eye test before administering antivenin. Answers A and D are unnecessary and therefore incorrect. Answer C would help calm the client but is not a priority before giving the antivenin, making it incorrect.