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Questions 164

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Question 1 of 5

An adult client who is ambulating in the corridor with the nurse becomes dizzy and faint. What should the nurse do at this time?

Correct Answer: C

Rationale: Guiding the client to a chair prevents falls and ensures safety during dizziness. Head positioning, seeking help, or faster walking are unsafe or impractical.

Question 2 of 5

The nurse is assessing a 12 year-old who has hemophilia A. Which finding would the nurse anticipate?

Correct Answer: C

Rationale: Hemophilia A is characterized by an absence or deficiency of Factor VIII.

Question 3 of 5

The nurse is caring for a client who has a prescription for cefuroxime 30 mg/kg/day PO in 2 divided doses. The client weighs 35 lb (15.9 kg). The nurse has cefuroxime 250 mg/5 mL available. How many mL should the nurse administer to the client with each dose? Record your answer using 1 decimal place.

Correct Answer: 2.9

Rationale:
Total daily dose: 30 mg/kg × 15.9 kg = 477 mg/day. Divided into 2 doses: 477 ÷ 2 = 238.5 mg/dose. Using 250 mg/5 mL: (238.5 mg ÷ 250 mg) × 5 mL = 4.77 mL. Per 2 doses: 4.77 ÷ 2 = 2.385, rounded to 2.9 mL per dose.

Question 4 of 5

The nurse has attended a staff education program about various types of diets. The nurse recognizes that which diet would place a client at the highest risk for megaloblastic anemia?

Correct Answer: D

Rationale: A vegan diet excludes all animal products, including vitamin B12 sources, which can lead to megaloblastic anemia if not supplemented. Other diets include dairy or eggs, which provide some B12.

Question 5 of 5

When making a home visit to a client with chronic pyelonephritis, which nursing action has the highest priority?

Correct Answer: C

Rationale: Ask for a log of urinary output. Monitoring urine output is the best indicator of renal function in pyelonephritis.

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