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Questions 158

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Question 1 of 5

Hematotympanum and otorrhea are associated with which of the following head injuries?

Correct Answer: A

Rationale: Basilar skull fractures are fractures of the base of the skull. Blood behind the eardrum or blood or cerebrospinal fluid (CSF) leaking from the ear are indicative of a dural laceration. Basilar skull fractures are the only type with these symptoms.

Question 2 of 5

A client with vaginal cancer is being treated with a radioactive vaginal implant. The client's husband asks the nurse if he can spend the night with his wife. The nurse should explain that:

Correct Answer: D

Rationale: Radioactive implants emit radiation posing a risk to others. Visitation is limited to short periods (e.g. 30 minutes) to minimize radiation exposure. The other options do not address the safety concern related to radiation.

Question 3 of 5

While obtaining information about the client's current medication use, the nurse learns that the client takes ginkgo to improve mental alertness. The nurse should tell the client to:

Correct Answer: A

Rationale: Ginkgo can increase bleeding risk by inhibiting platelet aggregation, so clients should report signs of bruising or bleeding to their doctor.

Question 4 of 5

The client is diagnosed with a pleural effusion. Which intervention should the nurse anticipate?

Correct Answer: B

Rationale: Thoracentesis is used to remove fluid from a pleural effusion, relieving respiratory distress. Chest tubes are for pneumothorax or persistent effusions, bronchoscopy is diagnostic, and nebulizers are irrelevant.

Question 5 of 5

A mother is unsure about the type of toys for her 17-month-old child. Based on knowledge of growth and development, what toy would the nurse suggest?

Correct Answer: A

Rationale: Increased locomotive skills make push-pull toys appropriate for the energetic toddler. Infants progress from reflex activity through simple repetitive behaviors to imitative behavior. Hand-eye coordination forms the foundation of other movements. At age 8 months, infants begin to have pincer grasp.
Toys that help infants develop the pincer grasp are recommended for this age group. Various large colored blocks are suggested toys for infants 6-12 months of age to help visual stimulation.

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