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Questions 149

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Question 1 of 5

Which of the following findings would be expected in the infant with biliary atresia?

Correct Answer: C

Rationale: Biliary atresia causes abdominal distention due to bile accumulation and poor weight gain due to malabsorption.

Question 2 of 5

A client has accidentally splashed a toxic (although not caustic) substance in his right eye and the nurse must flush the eye. Which of the following steps are correct? Select all that apply.

Correct Answer: B,C,D,E

Rationale: Correct eye irrigation includes syringe 0.5 inch above eye (
B), flushing 5 minutes (
C), holding eyelid open (
D), and using a basin (E). Head down (
A) is incorrect; tilt toward affected side.

Question 3 of 5

The nurse is talking with a client who has been diagnosed with thyroid cancer. The client is asking about different treatment options. Which response by the nurse is most appropriate?

Correct Answer: C

Rationale: This response encourages open communication and assesses the client's current knowledge, facilitating a patient-centered discussion about treatment options.

Question 4 of 5

During morning assessments, the nurse finds that a client's nephrostomy tube has been clamped. The nurse's first action should be to:

Correct Answer: C

Rationale: Unclamping the nephrostomy tube is the priority to restore urine flow and prevent obstruction or infection.

Question 5 of 5

A client is admitted with symptoms of pseudomembranous colitis. Which finding is associated with Clostridium difficile?

Correct Answer: A

Rationale: Clostridium difficile infection causes pseudomembranous colitis, characterized by diarrhea with blood and mucus due to toxin-mediated colonic inflammation.

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