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Questions 148

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Question 1 of 5

The nurse is caring for a client after a motor vehicle accident. The client has a fractured tibia, and bone is noted protruding through the skin. Which action is of priority?

Correct Answer: B

Rationale: An open fracture with protruding bone risks infection. Covering with a sterile dressing is the priority to prevent contamination. Traction or bandaging may worsen the injury.

Question 2 of 5

The physician prescribes regular insulin, 5 units subcutaneous. Regular insulin begins to exert an effect:

Correct Answer: C

Rationale: Regular insulin has an onset of 30-60 minutes when given subcutaneously.

Question 3 of 5

The client presents to the emergency room with a hyphema. Which action by the nurse would be best?

Correct Answer: A

Rationale: Elevating the head and applying ice reduces intraocular pressure and swelling in hyphema, a bleed in the eye.

Question 4 of 5

The home health nurse is visiting a client who plans to deliver her baby at home. Which statement by the client indicates an understanding regarding screening for phenylketonuria (PKU)?

Correct Answer: B

Rationale: PKU screening is typically performed at 2-3 days of age to ensure accurate results, as earlier testing may yield false negatives.

Question 5 of 5

A client is admitted to the medical-surgical unit with a report of severe hematemesis. The nurse should give priority to:

Correct Answer: C

Rationale: Severe hematemesis indicates significant bleeding, requiring immediate IV access with a large-bore needle for fluid and blood resuscitation to stabilize the client.

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