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Questions 149

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Extract:


Question 1 of 5

A home health nurse finds the client lying unconscious in the doorway of her bathroom. The nurse checks for responsiveness by gently shaking the client and calling her name. When it is determined that the client is nonresponsive, the nurse should:

Correct Answer: C

Rationale: Opening the airway is the first step in managing an unresponsive client to ensure adequate ventilation.

Question 2 of 5

Which of the following examples represents parallel play?

Correct Answer: B

Rationale: Parallel play involves children playing side by side with similar toys but without direct interaction, as described in the scenario with Jimmy and Mary.

Question 3 of 5

The nurse is caring for a client 7 days post-burn injury with 60% body surface area involved. The nursing care of this client would primarily focus on:

Correct Answer: A

Rationale: At 7 days post-burn, infection is a major risk due to open wounds and immunosuppression, making meticulous infection control the primary focus.

Question 4 of 5

A 9-year-old is admitted with suspected rheumatic fever. Which finding is suggestive of Sydenham's chorea?

Correct Answer: A

Rationale: Sydenham's chorea, a manifestation of rheumatic fever, is characterized by irregular, involuntary movements and facial grimacing.

Question 5 of 5

The nurse is assessing the abdomen. The nurse knows the best sequence to perform the assessment is:

Correct Answer: A

Rationale: The correct sequence is inspection, auscultation, palpation to avoid altering bowel sounds or causing discomfort during the exam.

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