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Questions 149

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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: Covering exposed viscera with sterile saline gauze keeps the tissue moist and prevents infection until surgical intervention, as replacing contents or using non-sterile dressings risks contamination.

Question 2 of 5

A client with bipolar disorder is taking lithium to control symptoms. Which of the following statements indicates the need for further education?

Correct Answer: B

Rationale: Lithium requires ongoing monitoring (B is incorrect), as levels and side effects need regular checks. Thyroid tests (
A), avoiding ibuprofen (
C), and hydration (
D) are correct.

Question 3 of 5

A client is admitted with disseminated herpes zoster. According to the Centers for Disease Control Guidelines for Infection Control:

Correct Answer: A

Rationale: Disseminated herpes zoster requires airborne precautions due to the risk of varicella-zoster virus transmission through respiratory droplets and contact.

Question 4 of 5

The nurse caring for the child with a large meningomylocele is aware that the priority care for this client is to:

Correct Answer: A

Rationale: Moist, sterile gauze prevents infection and drying of the meningomyelocele defect.

Question 5 of 5

A 46-year-old male has been placed under therapeutic hypothermic care after a myocardial infarction (MI). The nurse correctly explains to the family,

Correct Answer: C

Rationale: Therapeutic hypothermia post-MI slows metabolism, reducing cerebral oxygen demand and protecting the brain from ischemic injury.

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