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Questions 158

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Extract:


Question 1 of 5

A 19-year-old client fell off a ladder approximately 3 ft to the ground. He did not lose consciousness but was taken to the emergency department by a friend to have a scalp laceration sutured. The nurse instructs the client to:

Correct Answer: C

Rationale: Confusion, nausea, or vomiting may indicate increasing intracranial pressure from a possible head injury, requiring immediate evaluation.

Question 2 of 5

The nurse teaches a pregnant client that a high-risk symptom occurring at any time during pregnancy that needs to be reported immediately to a healthcare provider is:

Correct Answer: D

Rationale: Abdominal pain may be an indication of early spontaneous abortion, preterm delivery, or a placental abruption, requiring immediate medical attention.

Question 3 of 5

Home-care instructions for the child following a cardiac catheterization should include:

Correct Answer: B

Rationale: A small bruise may develop around the insertion site and is not a reason for alarm. It is best to keep the child out of the bathtub until the sutures are removed. Acetaminophen, not aspirin, is the drug of choice if there is pain at the insertion site. The insertion site should be kept clean and dry and open to air.

Question 4 of 5

A client with advanced Alzheimer’s disease has been prescribed haloperidol (Haldol). What clinical manifestation suggests that the client is experiencing side effects from this medication?

Correct Answer: B

Rationale: Haloperidol, an antipsychotic, commonly causes extrapyramidal side effects like tremors. Cough (
A), diarrhea (
C), and pitting edema (
D) are not typical side effects of haloperidol.

Question 5 of 5

Which term describes the play activity of the preschool aged child?

Correct Answer: B

Rationale: Preschool-aged children (3–5 years) typically engage in associative play, where they play together with shared activities but without formal rules or organization. Cooperative play develops later, parallel play is common in toddlers, and solitary play is seen in younger children.

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