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Questions 227

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Extract:

A mother reported that her son is throwing up each time she feeds him.


Question 1 of 5

What would be the best assessment question the nurse would ask?

Correct Answer: D

Rationale: Jelly-like stool is an indication of a gastrointestinal problem, which could be related to the vomiting. Assessing for this symptom helps identify potential underlying issues.

Extract:


Question 2 of 5

A Schilling test has been ordered for a client. What is the nurse's primary responsibility in relation to this test?

Correct Answer: B

Rationale: The Schilling test, used to diagnose pernicious anemia, requires a 24-hour urine collection to measure vitamin B12 absorption after radioactive B12 administration. Blood, x-rays, or enemas are not involved.

Extract:

Mr. Lou, 65 years old, with liver cirrhosis was ordered neomycin enema


Question 3 of 5

Mr. Lou, 65 years old, with liver cirrhosis was ordered neomycin enema for which of the following goals?

Correct Answer: B

Rationale: Neomycin enemas reduce ammonia-producing bacteria, improving consciousness in hepatic encephalopathy.

Extract:


Question 4 of 5

The nurse is caring for an adult who had a transsphenoidal hypophysectomy earlier today. The client is now on the surgical unit after an uneventful stay in the postanesthesia care unit. How should the nurse position the client?

Correct Answer: C

Rationale: Semi-reclining reduces intracranial pressure and prevents cerebrospinal fluid leakage post-transsphenoidal hypophysectomy. Supine increases leakage risk, and upright or side-lying are less optimal.

Extract:

When assessing a patient with pleural effusion, the nurse should expect to find:


Question 5 of 5

When assessing a patient with pleural effusion, the nurse should expect to find:

Correct Answer: C

Rationale: Pleural effusion causes fluid accumulation, reducing or eliminating breath sounds at the lung base.

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