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Questions 163

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Question 1 of 5

The nurse is assessing a 1-month-old infant with atrial septal defect. Which of the following findings would be consistent with the condition?

Correct Answer: C

Rationale: An atrial septal defect often presents with a heart murmur due to abnormal blood flow. Cyanosis is rare unless severe, muffled tones are not typical, and weak femoral pulses suggest coarctation of the aorta.

Question 2 of 5

A woman brings her 6-month-old daughter to a clinic for a checkup and immunizations. The mother tells the nurse that her infant is cranky, has a bad cold, and has not eaten well the last days. She asks if the baby will still be able to get her shots. The child's temperature is 100.8°F. How should the nurse respond?

Correct Answer: B

Rationale: Mild fever and illness contraindicate vaccinations due to potential reduced immune response and difficulty distinguishing vaccine reactions from illness symptoms.

Question 3 of 5

The registered nurse and practical nurse are conducting a workshop on contraceptive methods for a group of outpatient clients. Which instructions should the nurses include when discussing combined estrogen-progestin oral contraceptives? Select all that apply.

Correct Answer: A,C,E

Rationale: For combined oral contraceptives: report leg pain/swelling for possible DVT; avoid smoking due to increased cardiovascular risk; and seek treatment for vision loss indicating possible stroke. Spotting is common and breast tenderness is not urgent.

Question 4 of 5

The nurse is planning care for a client during the acute phase of a sickle cell vaso-occlusive crisis. Which of the following actions would be most appropriate?

Correct Answer: C

Rationale: Administer analgesic therapy as ordered. Pain management is critical during a sickle cell crisis.

Question 5 of 5

The nurse is assisting in the attempt to control bleeding from an artery. What personal protection equipment should be worn?

Correct Answer: B

Rationale: Gown, gloves, mask, and goggles protect against blood splatter during arterial bleeding control, adhering to standard precautions.

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