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Questions 149

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Question 1 of 5

A 6-year-old with cerebral palsy functions at the level of an 18-month-old. Which finding would support that assessment?

Correct Answer: B

Rationale: Pulling a toy is consistent with an 18-month-old's developmental level, supporting the assessment.

Question 2 of 5

A client with osteomylitis has an order for a trough level to be done because he is taking Gentamycin. When should the nurse call the lab to obtain the trough level?

Correct Answer: B

Rationale: Trough levels measure the lowest drug concentration and are drawn just before a dose after steady-state, typically around the fourth dose for Gentamicin.

Question 3 of 5

The graduate nurse is assigned to care for the client on ventilator support, pending organ donation. Which goal should receive priority?

Correct Answer: A

Rationale: Adequate blood pressure ensures organ perfusion for donation.

Question 4 of 5

The nurse is obtaining a history on a 74-year-old client. Which statement made by the client would alert the nurse to a possible fluid and electrolyte imbalance?

Correct Answer: B

Rationale: Frequent laxative use can cause fluid and electrolyte losses (e.g., potassium, sodium), leading to imbalances, unlike the other statements.

Question 5 of 5

The nurse on the 3-11 shift is assessing the chart of a client with an abdominal aneurysm scheduled for surgery in the morning and finds that the consent form has been signed, but the client is unclear about the surgery and possible complications. Which is the most appropriate action?

Correct Answer: A

Rationale: The surgeon is responsible for ensuring informed consent, so contacting them to clarify the procedure and complications with the client is the most appropriate action.

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