The nurse is caring for a client with a vascular access for hemodialysis. Which of these findings necessitates immediate action by the nurse?

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Question 1 of 5

The nurse is caring for a client with a vascular access for hemodialysis. Which of these findings necessitates immediate action by the nurse?

Correct Answer: D

Rationale: Fever may indicate infection at the access site, a medical emergency in dialysis patients.

Question 2 of 5

An elderly client is on an anticholinergic metered dose inhaler (MDI) for chronic obstructive pulmonary disease. The nurse would suggest a spacer to

Correct Answer: C

Rationale: Spacers aid coordination, ensuring more drug reaches the lungs in elderly patients.

Question 3 of 5

A client has been receiving dexamethasone (Decadron) for control of cerebral edema. Which of the following assessments would indicate that the treatment is effective?

Correct Answer: B

Rationale: Improved motor response indicates reduced cerebral edema and pressure.

Question 4 of 5

A nurse is assigned to perform well-child assessments at a day care center. A staff member interrupts the examinations to ask for assistance. They find a crying 3 year-old child on the floor with mouth wide open and gums bleeding. Two unlabeled open bottles lie nearby. The nurse's first action should be

Correct Answer: A

Rationale: Poison control provides immediate guidance; 911 ensures rapid medical response.

Question 5 of 5

For which of the following mother-baby pairs should the nurse review the Coombs' test in preparation for administering Rho immune globulin within 72 hours of birth?

Correct Answer: A

Rationale: Rh-negative mother with Rh-positive baby risks sensitization; Coombs' test confirms antibody presence before RhoGAM.

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