NACE EXAM — Health Care exam material
HEAL100 · Other
HEAL100 Health Care — exam and revision material · Other
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Health Care exam material, 46 pages. Originally published on StudyMerit.
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lOMoAR cPSD| 57819357 NCLEX - PN 3 00 Questions with Correct and Verified Answers and Rationale. GRADED A+ The parent of a preschooler with chickenpox asks the nurse about measures to make the child comfortable. The nurse instructs the parent to avoid administering aspirin or any other product that contains salicylates. When given to children with chickenpox, aspir in has been linked to which disorder? 1. Guillain - Barré syndrome 2. Rheumatic fever 3. Reye's syndrome 4. Scarlet fever - Correct answer Correct Answer: 3 RATIONALES : Research shows a correlation between the use of aspirin during chickenpox and the development of Re ye's syndrome (a disorder characterized by brain and liver toxicity). Therefore, the nurse should instruct the parents to avoid administering aspirin or other products that contain salicylates and to consult the physician or pharmacist before administering any medication to a child with chickenpox. No research has found a link between aspirin use, chickenpox, and the development of Guillain - Barré syndrome, rheumatic fever, or scarlet fever." "A client is to have an epidural block to relieve labor pain. The nurse anticipates that the anesthesiologist will inject the anesthetic agent into the: subarachnoid space. 1. area between the subarachnoid space and the dura mater. 2. area between the dura mater and the ligamentum flavum. 3. ligamentum flavum. - Correct answer Correct Answer: 3 RATIONALES : For an epidural block, the nurse should anticipate that the anesthesiologist will inject a local anesthetic agent into the epidural sp ace, located between the dura mater and the ligamentum flavum in the lumbar region of the spinal column. When administering a spinal block, the anesthesiologist injects the anesthetic agent into the subarachnoid space. The lig amentum flavum
lOMoAR cPSD| 57819357 and the area be tween the subarachnoid space and the dura mater are inappropriate injection sites." "The physician prescribes penicillin potassium oral suspension 56 mg/kg/day in four divided doses for a client with anorexia nervosa who weighs 25 kg. The medication dispen sed by the pharmacy contains a dosage strength of 125 mg/5 ml. How many milliliters of solution should the nurse administer with each dose? - Correct answer Correct Answer: 14 RATIONALES : To determine the total daily dosage, set up the following proportion : 25 kg/X = 1 kg/56 mg X = 1,400 mg. Next, divide the daily dosage by four doses to determine the dose to administer every 6 hours: X = 1,400 mg/4 doses X = 350 mg/dose. The adolescent should receive 350 mg every 6 hours. Lastly, calculate the volume to gi ve for each dose by setting up this proportion: X/350 mg = 5 ml/125 mg X = 14 ml." "The nurse must irrigate a gaping abdominal incision with sterile normal saline, using a piston syringe. How should the nurse proceed? 1. Irrigate continuously until the solution becomes clear or all of the solution has been used. 2. Moisten the area around the wound with normal saline after the irrigation. 3. Apply a wet - to - dry dressing to the wound after the irrigation. 4. Rapidly instill a str eam of irrigating solution into the wound. - Correct answer Correct Answer: 1 RATIONALES: To wash away tissue debris and drainage effectively, the nurse should irrigate the wound until the solution becomes clear or all of the solution has been used. After the irrigation, the nurse should dry the area around the wound; moistening it promotes microorganism growth and skin irritation. When the area is dry, the nurse should apply a sterile dressing, rather than awet - todry dressing. The nurse always should insti ll the irrigating solution gently; rapid or forceful instillation can damage tissues." "As an adolescent is receiving care, he's inadvertently injured with a warm compress. The nurse completes an incident report based on the knowledge that identification o f which of the following is a goal of the report? To reprimand the involved staff members for their actions 1. To identify the learning needs of staff to prevent incident recurrences 2. To reprimand the nurse - manager responsible for the unit
lOMoAR cPSD| 57819357 3. To hold peop le accountable for their actions - Correct answer Correct Answer: 2 RATIONALES: The purpose of an incident report is threefold: to identify ways to prevent incident recurrences, to identify patterns of care problems, and to identify facts surrounding each incident. Incident reports aren't used to hold people accountable for their actions, to punish those involved in the incident, or to punish the nurse - manager responsible for the unit." "As a client progresses through pregnancy, she develops constipation. W hat is the primary cause of this problem during pregnancy? 1. Decreased appetite 2. Inadequate fluid intake 3. Prolonged gastric emptying 4. Reduced intestinal motility - Correct answer Correct Answer: 4 RATIONALES: During pregnancy, hormonal changes and mechanical pressure reduce motility in the small intestine, enhancing water absorption and promoting constipation. Although decreased appetite, inadequate fluid intake, and prolonged gastric emptying may c ontribute to constipation, they aren't the primary cause." "An adolescent with type 1 diabetes mellitus is experiencing a growth spurt. Which treatment approach would be most effective for this client? 1. Administering insulin once per day 2. Administering m ultiple doses of insulin 3. Limiting dietary fat intake 4. Substituting an oral antidiabetic agent for insulin - Correct answer Correct Answer: 2 RATIONALES: During an adolescent growth spurt, a regimen of multiple insulin doses achieves better control of the bl ood glucose level because it more closely simulates endogenous insulin release. A single daily dose of insulin wouldn't control this client's blood glucose level as effectively. Limiting dietary fat intake wouldn't help the body use glucose at the cellular level. An adolescent with type 1 diabetes mellitus doesn't produce insulin and therefore can't receive an oral antidiabetic agent instead of insulin." "A client is admitted to the health care facility with bowel obstruction secondary to colon cancer. The nurse obtains a health history, measures vital signs, and auscultates for bowel sounds. Which step of the nursing process is the nurse performing?
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