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Question 1 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 2 of 5

The client with preeclampsia is admitted to the unit with an order for magnesium sulfate. Which action by the nurse indicates the understanding of magnesium toxicity?

Correct Answer: C

Rationale: Inserting a Foley catheter allows monitoring of urinary output, which is critical to detect magnesium toxicity, as decreased output is a sign of toxicity.

Question 3 of 5

The nurse is assessing the deep tendon reflexes of a client with preeclampsia. Which method is used to elicit the biceps reflex?

Correct Answer: A

Rationale: The biceps reflex is elicited by placing the thumb on the biceps tendon in the antecubital space and tapping it with a reflex hammer.

Question 4 of 5

The nurse employed in the emergency room is responsible for triage of four clients injured in a motor vehicle accident. Which of the following clients should receive priority in care?

Correct Answer: B

Rationale: Sternal bruises suggest potential chest trauma, requiring priority.

Question 5 of 5

The nurse is preparing to administer a dose of lisinopril (Zestril) to a client with hypertension. The client’s blood pressure is 100/60 mmHg. Which of the following actions should the nurse take?

Correct Answer: B

Rationale: lisinopril is an ACE inhibitor

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