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Questions 158

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Question 1 of 5

The physician has prescribed Nexium (esomeprazole) for a client with erosive gastritis. The nurse should administer the medication:

Correct Answer: A

Rationale: Esomeprazole (Nexium) a proton pump inhibitor is most effective when taken 30 minutes before breakfast to suppress acid production before meals. Taking it with or after meals or at bedtime is less optimal for gastritis treatment.

Question 2 of 5

The physician orders the removal of an in-dwelling catheter the second post-operative day for a client with a prostatectomy. The client complains of pain and dribbling of urine the first time he voids. The nurse should tell the client that:

Correct Answer: D

Rationale: Pain and dribbling post-catheter removal after prostatectomy are common due to bladder irritation and will improve with time. Compresses, exercises, or reinsertion are not typically needed.

Question 3 of 5

A 6-month-old infant has developmental delays. His weight falls below the 5th percentile when plotted on a growth chart. A diagnosis of failure to thrive is made. What behaviors might indicate the possibility of maternal deprivation?

Correct Answer: B

Rationale: Normal infant attachment behaviors include responding to touch and wanting to be held. Maternal deprivation behaviors include poor feeding, stiffening and refusal to eat, and inconsistencies in responsiveness. Attachment behavior includes maintaining eye contact. Maternal deprivation behaviors include displeasure with touch and physical contact.

Question 4 of 5

The client is admitted with a suspected bowel obstruction. Which diagnostic test is most likely to confirm the diagnosis?

Correct Answer: A

Rationale: An abdominal X-ray is the initial test to confirm bowel obstruction, showing air-fluid levels or dilated loops of bowel. Barium enema and colonoscopy are contraindicated due to perforation risk, and ultrasound is less specific.

Question 5 of 5

A 14-year-old boy has a head injury with laceration of his scalp over his ear. The nurse should call the physician to report:

Correct Answer: D

Rationale: This change in blood pressure may not be significant and does not indicate a widening pulse pressure, a late sign of increased ICP. It is important to continue to monitor for change in blood pressure. Acetaminophen may be ineffective in relieving headache after head injury. Stronger analgesics are contraindicated because they mask neurological signs and may depress the CNS. Pulse rates between 68 bpm and 76 bpm are within normal limits for a 14-year-old child. It is important to monitor for a consistent drop in pulse rate, which is a late sign of increasing ICP. An elevated temperature is abnormal and requires further assessment and medical intervention. The temperature may be unrelated to the head injury, but CNS infection is serious and difficult to control.

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