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Questions 148

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Extract:


Question 1 of 5

A client is admitted to the medical-surgical unit with a report of severe hematemesis. The nurse should give priority to:

Correct Answer: C

Rationale: Severe hematemesis indicates significant bleeding, requiring immediate IV access with a large-bore needle for fluid and blood resuscitation to stabilize the client.

Question 2 of 5

The nurse gives a 35-year-old primigravida client a RhoGAM injection in her 27th week of pregnancy. Which of the following client situations requires the nurse to take this action?

Correct Answer: A

Rationale: RhoGAM is given to an Rh-negative mother with an Rh-positive father to prevent Rh incompatibility issues in the fetus.

Question 3 of 5

A client is admitted to the emergency room after falling down a flight of stairs. Initial assessment reveals a large bump on the front of the head and a 2-inch laceration above the right eye. Which finding is consistent with injury to the frontal lobe?

Correct Answer: C

Rationale: The frontal lobe is involved in sensory processing and cognition, so failure to recognize touch (agnosia) is consistent with frontal lobe injury.

Question 4 of 5

The nurse has orders for dopamine at 20 mcg/kg/min. The bag has 500 mg of dopamine in 500 mL. The client weighs 60 kg. What rate will the nurse set?

Correct Answer: 72 mL/hr

Rationale: Dose: 20 mcg/kg/min × 60 kg = 1200 mcg/min. Concentration: 500 mg/500 mL = 1 mg/mL = 1000 mcg/mL. Rate: 1200 mcg/min ÷ 1000 mcg/mL = 1.2 mL/min × 60 min/hr = 72 mL/hr.

Question 5 of 5

The client with cirrhosis of the liver is receiving Lactulose. The nurse is aware that the rationale for the order for Lactulose is:

Correct Answer: C

Rationale: Lactulose reduces ammonia levels to prevent hepatic encephalopathy.

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