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126. Which of the following statements. if made by a parent, would indicate the need for further investigation?
A. "Whenever my five-year-old disobeys, he is instructed to go into’time out’for five minutes.”
B. "Whenever my 10-year-old fails a test, we ask the teacher to re-teach the information.”
C. "Whenever my two-year-old wets the bed at naptime, we withhold fluids for the remainder of the day.”
D. "Whenever my one-year-old drops an item，we pick it up.”
127. A patient hospitalized for a physical illness exhibits restlessness, tremors. elevated temperature, elevated blood pressure. Complaints of night time leg cramps and diaphoresis within two days of admission. The nurse should recognize that these symptoms suggest
A. a systemic infection.
B. gastrointestinal hypermotility.
C. alcohol withdrawal.
D. neurologic dysfunction.
128. A nurse is performing a neurological check on a patient who is one day post-craniotomy. The nurse notices that the patient's eyes are not conjugated when turned right laterally. Which of the following cranial nerves should the nurse suspect is damaged?
A. Cranial nerve II一optic
B. Cranial nerve V一trigeminal
C. Cranial nerve VI一abducens
D. Cranial nerve VII一facial
129. A 12-month-old received immunizations at his well-child visit. Fourteen days later, the mother reports that the child has a fire-red maculo-papular rash on the trunk and extremities.This rash is most likely due to which of the following vaccines?
A. DTP (diphtheria. tetanus, pertussis)
B. OPV (oral poliovirus vaccine)
C. MMR (measles, mumps. rubella)
D. Hib (Haemophilus influenzae type b)
130. When teaching parents first aid for minor burns, a nurse should instruct the parents to
A. cover the burned area with cotton gauze.
B. apply ice directly to the burned area.
C. coat the burned area lightly with petroleum jelly.
D immerse the burned area in cool water.
昨天答案解析
121. Key: C
Client Need: Prevention and Early Detection of Disease
C. This pain may be of peritoneal origin. This type of pain is well-localized pain that causes rigidity of the abdominal muscles. The pain increases with any pressure or motion. Patients breathe shallowly and keep movement to a minimum to reduce pain.
A. Pain of renal origin begins in the flank area and may radiate to the lower abdomen and groin.
B. Pain of biliary origin is right upper quadrant pain that may radiate to the right shoulder.
D. Pain of meningeal origin is associated with headache, nuchal rigidity, and stiff neck. Pain is present when the neck is flexed toward the chest.
122. Key: A
Client Need: Management of Care
A. The nurse manager needs to assist an impaired nurse in obtaining treatment for his / her substance abuse. The treatment process can be initiated when a team of colleagues confronts the nurse and offers him/her assistance in seeking treatment.
B. Termination of an impaired nurse will protect the safety of the patients, but does not assist the nurse in obtaining necessary treatment. The nurse should be removed from his/her role until he / she has received and responded successfully to treatment. Termination only serves to promote the growth of the problem. The nurse often can obtain employment in another healthcare facility.
C. The impaired nurse needs to be removed from the professional duties and responsibilities of his / her job but should not be professionally isolated. The professional future of the impaired nurse should be considered and a humane system of intervention and treatment provided.
D. By providing covert support. the nurse manager not only is promoting the growth of the problem in the impaired nurse but also is jeopardizing the safety of patients and increasing the risk for health care employers.
123. Key: D
Client Need, Growth and Development
D. Fetal death is common with a high energy, direct blow to the abdomen. Maternal death is found in 10% of cases, but when it does occur, it is the result of massive injuries as well as uterine rupture.
A. Placenta previa is associated with a placenta that is attached in the lower segment of the uterus,sometimes covering the cervical os. Bleeding may be the result of a previa if it occurs after 24 weeks. It is not a result of trauma.
B. Preterm labor should be evaluated via an electronic fetal monitor whenever the patient states that she thinks she is having regular contractions. Trauma does increase the incidence of preterm labor.but preterm labor does not usually cause both maternal and fetal mortality.
C. The incidence of spontaneous abortion is also increased by trauma to the mother. Spontaneous abortion does not usually increase maternal mortality.
124. Key: B
Client Need: Physiological Adaptation
B. LarynRotracheobronchitis (LTB) is the most common type of croup experienced by children under five years of age that results in hospitalization. Inflammation of the mucosal lining of the larynx and trachea causes narrowing of the airway. resulting in the child having difficulty inhaling air past the narrowed structures of the lungs. The child will have a classic inspiratory stridor and suprasternal retractions. Hoarseness and a cough that sounds like a barking seal may also be present. The child frequently has a low-grade fever.
A. Drooling, dysphagia and high fever are signs of acute epiglottitis.
C. Restlessness. absent breath sounds and high fever are abnormal assessment findings. Collectively,they are not indicative of a particular illness.
D. A low-grade fever may indicate that an infection is present. Purulent nasal drainage is commonly seen in children with an upper respiratory infection. Clear breath sounds may be heard in a child with an upper respiratory infection. but more commonly there are abnormal breath sounds such as coarseness or wheezing present.
125. Key: D
Client Need: Management of Care
D. The healthcare team is made up of nurses, physicians, allied health professionals and specialists. The registered nurse is most often responsible for coordinating and integrating services. because the nurse has the opportunity to interact with all team members.
A. Serving as group facilitator is not the role of the nurse on the health team. The purpose of the team is to discuss the patient's plan of care. The nurse will bring to the discussion the plan of care that identifies the patient's nursing care needs.
B. The purpose of team discussion is the elderly patient's plan of care. It is not the role of the nurse to identify members who don't understand the nursing role. It is the nurse's role to contribute to the professional development of colleagues and to share knowledge and skills.
C. Collaborating with other health team members. rather than promoting one's own recommendations,is key to preventing fragmentation of the elderly patient's plan of care.
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