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Questions 148

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Question 1 of 5

The nurse is caring for a 72-year-old female who must remain on bed rest after a hip fracture. The client has become confused and disoriented over the past 2 days. Which of the following is the best nursing intervention?

Correct Answer: A

Rationale: Familiar objects like photos, clocks, and calendars help reorient a confused client, reducing disorientation safely. Restraints are a last resort, and the other options are less effective.

Question 2 of 5

The client is receiving peritoneal dialysis. If the dialysate returns cloudy, the nurse should:

Correct Answer: B

Rationale: Cloudy dialysate suggests peritonitis, requiring lab analysis.

Question 3 of 5

The nurse is developing a care plan for a client with hepatitis A. The nurse knows that the primary routes of transmission of this hepatitis virus are which of the following? Select all that apply.

Correct Answer: C,D

Rationale: Hepatitis A is transmitted primarily via the fecal-oral route, through contaminated food or water (
D) and feces (
C).

Question 4 of 5

A client with a head injury develops syndrome of inappropriate antidiuretic hormone (SIADH). Which physician prescription would the nurse question?

Correct Answer: A

Rationale: D5W at 200 mL/hr is inappropriate for SIADH, as it can worsen hyponatremia by adding free water. The other options are appropriate for monitoring and treating SIADH.

Question 5 of 5

The nurse is assigned to care for the client with a Steinmen pin. During pin care, she notes that the LPN uses sterile gloves and Q-tips to clean the pin. Which action should the nurse take at this time?

Correct Answer: A

Rationale: Sterile technique is appropriate for pin care; assisting maintains the sterile field.

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