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Question 1 of 5

A two-year-old is being evaluated for hearing loss. Which finding in the child's history is likely to be a significant factor?

Correct Answer: D

Rationale: Meningitis treated with garamycin (gentamicin) is a significant risk factor for hearing loss as gentamicin is ototoxic and meningitis can damage auditory nerves. The other factors are less directly associated with hearing impairment.

Question 2 of 5

The nurse is caring for a client with a diagnosis of preeclampsia. Which intervention is most appropriate?

Correct Answer: D

Rationale: Magnesium sulfate prevents seizures blood pressure monitoring tracks hypertension and antihypertensives (e.g. hydralazine) manage severe hypertension in preeclampsia. All interventions are appropriate.

Question 3 of 5

A nurse is assisting the physician with chest tube removal. Which client instruction is appropriate during removal of the tube?

Correct Answer: A

Rationale: Taking a deep breath or humming (Valsalva maneuver) during chest tube removal increases intrathoracic pressure, preventing air entry. Holding breath for two minutes (
B) is excessive, exhaling (
C) risks pneumothorax, and deep breathing (
D) is unsafe.

Question 4 of 5

A male client was involved in a motor vehicle accident earlier in the day. The nurse caring for him on evenings notices that on admission to the hospital, he lost a lot of blood and required multiple blood transfusions. The nurse would anticipate which blood product would be ordered when a large blood loss has occurred?

Correct Answer: A

Rationale: Whole blood is the transfusion component of choice when large volumes of blood need to be replaced. Whole blood contains all blood components that are lost during active bleeding.

Question 5 of 5

The physician has prescribed Coumadin (sodium warfarin) for a client having transient ischemic attacks. Which laboratory test measures the therapeutic level of Coumadin?

Correct Answer: A

Rationale: Prothrombin time (PT/INR) measures Coumadin's anticoagulant effect by assessing clotting time. PTT monitors heparin, and clot retraction or bleeding time are unrelated.

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