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Questions 158

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Extract:


Question 1 of 5

The nurse is assessing a trauma client in the emergency room when she notes a penetrating abdominal wound with exposed viscera. The nurse should:

Correct Answer: B

Rationale: Exposed viscera should be covered with sterile saline-soaked gauze to keep them moist and prevent infection until surgical repair. Replacing contents or using non-sterile/petroleum dressings is unsafe.

Question 2 of 5

A new mother tells the nurse that she is getting a new microwave so that her husband can help prepare the baby's feedings. The nurse should:

Correct Answer: A

Rationale: Microwaving baby bottles can cause uneven heating, leading to burns, so it should be avoided; warming under running water or in a bottle warmer is safer.

Question 3 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 4 of 5

The orthopedic nurse should be particularly alert for a fat embolus in which of the following clients having the greatest risk for this complication after a fracture?

Correct Answer: C

Rationale: Fat embolus is most common in long bone fractures, especially the femur, and in young adults. A 21-year-old with a femur fracture (
C) is at highest risk. Fibula (
A), wrist (
B), and arm (
D) fractures have lower risk.

Question 5 of 5

A client with a history of tuberculosis is admitted with complaints of hemoptysis. The nurse should give priority to:"

Correct Answer: B

Rationale: Hemoptysis in tuberculosis indicates potential lung tissue damage, so monitoring respiratory status is critical to assess for airway compromise or worsening infection.

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