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Questions 149

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Question 1 of 5

Which of the following would be considered a sensible type of fluid loss?

Correct Answer: A

Rationale: Sensible fluid loss is measurable, such as sweat or urine. Respiratory excretions, vomit, and fecal water loss are insensible (not easily measured).

Question 2 of 5

The nurse calculates the amount of an antibiotic for injection to be given to an infant. The amount of medication to be administered is 1.25 mL. The nurse should:

Correct Answer: A

Rationale: For infants, volumes greater than 1 mL should be divided and administered in separate sites, such as each vastus lateralis, to reduce discomfort and ensure absorption.

Question 3 of 5

A 52-year-old female had a hysterectomy 3 days ago and is recovering on the post-op floor. She is scheduled for an oral pain medication every 4 hours. She received her scheduled dose 1 hour ago but pushes the call light and complains of unrelenting and severe pain. The nurse should first

Correct Answer: D

Rationale: Severe, unrelenting pain post-hysterectomy suggests a complication (e.g., bleeding, infection). Notifying the physician for evaluation is the priority.

Question 4 of 5

The nurse has assessed the assigned group of clients. Which client would the nurse identify as being at the greatest risk for alterations in sensory perception?

Correct Answer: B

Rationale: Severe autism often involves sensory processing issues, increasing risk for sensory perception alterations, especially during stressful procedures like surgery.

Question 5 of 5

A client is admitted to the emergency room with multiple injuries. What is the proper sequence for managing the client?

Correct Answer: C

Rationale: The ABCs of trauma care prioritize airway, breathing, and circulation. Establishing an airway comes first, followed by controlling hemorrhage and preventing shock, then assessing for head injuries.

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