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Questions 149

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Question 1 of 5

A client is given morphine 6 mg IV push for postoperative pain. Following administration of this drug, the nurse observes the following: pulse 68, respirations 8, BP 100/68, client sleeping quietly. Which of the following nursing actions is MOST appropriate?

Correct Answer: C

Rationale: IV naloxone (Narcan) should be given to reverse respiratory depression; respiratory rate of 8 is too low and necessitates a nursing action

Question 2 of 5

The nurse is caring for a 12-year-old client with appendicitis. The client's mother is a Jehovah's Witness and refuses to sign the blood permit. What nursing action is most appropriate?

Correct Answer: D

Rationale: Notifying the physician respects the mother's beliefs while ensuring the medical team addresses the refusal appropriately.

Question 3 of 5

The nurse is providing post-op education to a client who had a splenectomy. Which statement by the client indicates that the nurse's teaching was successful?

Correct Answer: D

Rationale: Post-splenectomy clients are at risk for infections and require vaccines like influenza, pneumococcal, and meningococcal, indicating successful teaching.

Question 4 of 5

The mother of a 1-year-old with sickle cell anemia wants to know why the condition didn't show up in the nursery. The nurse's response is based on the knowledge that:

Correct Answer: D

Rationale: Fetal hemoglobin, present in newborns, inhibits sickling, masking sickle cell anemia symptoms until fetal hemoglobin decreases after several months.

Question 5 of 5

A behavior-modification program has been started for an adolescent with oppositional defiant disorder. Which statement describes the use of behavior modification?

Correct Answer: C

Rationale: Behavior modification often uses token economies and rewards to reinforce positive behaviors, encouraging their repetition in disorders like ODD.

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