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Questions 149

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Question 1 of 5

The nurse is taking care of a 12-year-old male who sustained 30% full-thickness burns on his chest and arms 20 hours ago. To maintain optimal fluid and electrolyte balance, the nurse expects to administer which of the following?

Correct Answer: A

Rationale: Lactated Ringer's is the standard fluid for burn resuscitation to restore fluid and electrolyte balance, as it closely mimics the body's extracellular fluid.

Question 2 of 5

A child with scoliosis has a spica cast applied. Which action specific to the spica cast should be taken?

Correct Answer: D

Rationale: Checking for swelling is critical to detect complications like compartment syndrome in a spica cast.

Question 3 of 5

The nurse is teaching the client with polycythemia vera about prevention of complications of the disease. Which of the following statements by the client indicates a need for further teaching?

Correct Answer: A

Rationale: Limiting fluid intake to 500 mL per day is incorrect, as adequate hydration is essential in polycythemia vera to reduce blood viscosity and prevent thrombosis.

Question 4 of 5

A nurse is preparing to lift a client up in bed. Which of the following should the nurse do to help avoid injuring his back?

Correct Answer: C

Rationale: Tightening stomach and leg muscles stabilizes the core, reducing back strain during lifting.

Question 5 of 5

The nurse is monitoring a client following a lung resection. The hourly output from the chest tube was 300 mL. The nurse should give priority to:

Correct Answer: D

Rationale: A chest tube output of 300 mL per hour is excessive and may indicate hemorrhage, requiring immediate physician notification.

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