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Questions 157

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Extract:

A five-year-old girl after the application of a cast to the left arm.


Question 1 of 5

After the cast is applied, the nurse should

Correct Answer: B

Rationale: Strategy: Answers are implementations. Determine the outcome of each answer choice. Is it desired? (1) done when cast is completely dry, prevents crumbling of plaster into cast (2) correct-minimizes swelling, elevated for first 24-48 hours, protects from pressure and flattening of cast (3) would delay drying of cast (4) maintaining mobility of fingers not most important after application of cast

Extract:


Question 2 of 5

The nurse must know that the most accurate oxygen delivery system available is

Correct Answer: A

Rationale: The most accurate way to deliver oxygen to the client is through a Venturi system such as the Venti Mask. The Venti Mask is a high flow device that entrains room air into a reservoir device on the mask and mixes the room air with 100% oxygen. The size of the opening to the reservoir determines the concentration of oxygen. The client's respiratory rate and respiratory pattern do not affect the concentration of oxygen delivered. The maximum amount of oxygen that can be delivered by this system is 53%.

Question 3 of 5

Delirium tremens could best be described as

Correct Answer: C

Rationale: An excited state accompanied by disorientation, hallucination and tachycardia. Delirium tremens involves severe withdrawal symptoms, including confusion, hallucinations, and autonomic hyperactivity.

Question 4 of 5

The nurse is caring for a newborn with tracheoesophageal fistula. Which nursing diagnosis is a priority?

Correct Answer: B

Rationale: The most common form of TEF is one in which the proximal esophageal segment terminates in a blind pouch and the distal segment is connected to the trachea or primary bronchus by a short fistula. Thus, a priority is maintaining an open airway, preventing aspiration.

Question 5 of 5

After admission for elective surgery, an adult says to the nurse, 'They asked me if I had advance directives. I don't even know what that is.' What is the best response by the nurse?

Correct Answer: B

Rationale: Advance directives specify healthcare preferences for incapacitation, relevant for any adult, clearly explaining their purpose.

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