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Questions 148

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Question 1 of 5

Which statement by the client regarding sickle cell disease indicates a need for further teaching?

Correct Answer: B

Rationale: Alcohol, including red wine, can cause dehydration and increase the risk of sickle cell crisis, so it should be avoided. Other statements are correct.

Question 2 of 5

The nurse is caring for a client who is receiving continuous bladder irrigation following a transurethral resection of the prostate (TURP). The nurse notes that the urine output is bright red with clots. Which of the following actions should the nurse take FIRST?

Correct Answer: B

Rationale: bright red urine with clots indicates potential bleeding, requiring immediate physician notification

Question 3 of 5

The physician has made a diagnosis of 'shaken child' syndrome for a 13-month-old who was brought to the emergency room after a reported fall from his highchair. Which finding supports the diagnosis of 'shaken child' syndrome?

Correct Answer: C

Rationale: Retinal hemorrhages are a hallmark of shaken baby syndrome due to the shearing forces from violent shaking causing bleeding in the retina.

Question 4 of 5

A mother brings her two-year-old boy to the pediatrician’s office. Which of the following symptoms would suggest to the nurse that the child has strabismus?

Correct Answer: C

Rationale: visual axes are not parallel so the brain receives two images

Question 5 of 5

A 4-month-old is brought to the well-baby clinic for immunization. In addition to the DPT and polio vaccines, the baby should receive:

Correct Answer: C

Rationale: At 4 months, the hepatitis B vaccine is part of the standard immunization schedule, along with DPT and polio vaccines.

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