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Questions 164

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Question 1 of 5

A client is admitted with a pressure ulcer in the sacral area. The partial thickness wound is 4 cm by 7 cm, the wound base is red and moist with no exudate and the surrounding skin is intact. Which of the following coverings is most appropriate for this wound?

Correct Answer: D

Rationale: Occlusive moist dressing. This supports healing by maintaining a moist environment for granulation tissue.

Question 2 of 5

A 4-year old is scheduled for a routine tonsillectomy. Which of the following lab findings should be reported to the doctor?

Correct Answer: C

Rationale: A white cell count of 16,000 is elevated, suggesting infection, which must be reported before surgery. Hemoglobin , platelets , and urine specific gravity are normal.

Question 3 of 5

The nurse is talking with the parent of a pediatric client with type 1 diabetes mellitus who has influenza. Which of the following statements by the parent would require follow-up?

Correct Answer: D

Rationale: Decreasing insulin during illness can lead to hyperglycemia or ketoacidosis, as insulin needs may increase.

Question 4 of 5

Which of the following signs is highly suggestive of impaired hearing in an infant?

Correct Answer: B

Rationale: Absence of babbling by 7 months is a red flag for hearing impairment, as infants typically begin vocalizing in response to sounds. Other signs are less specific to hearing.

Question 5 of 5

The nurse is caring for a 67-year-old client with postherpetic neuralgia who has a new prescription for amitriptyline. Which of the following actions would be a priority for the nurse to take?

Correct Answer: C

Rationale: Amitriptyline can cause orthostatic hypotension, making slow position changes a priority to prevent falls.

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