A home health nurse is reviewing messages from a group of clients. Which of the following clients should the nurse contact first?
A mother who reports that her son vomited after a dose of methylphenidate
A client who has COPD and reports an oxygen saturation of 90%
A client who reports that her new colostomy stoma appears purple
A client who reports feeling a vibration in his new internal arteriovenous graft for dialysis
The Correct Answer is C
The mother reporting vomiting in choice A may be concerning, but it is a known side effect of methylphenidate, and the client should be monitored for any further symptoms. A client who has COPD and reports an oxygen saturation of 90%. An oxygen saturation of 90% in COPD is within normal due to the chronic hypoxia.The purple appearance of a colostomy stoma in choice C may indicate ischemia or necrosis, and is an urgent concern.The feeling of a vibration in a new arteriovenous graft for dialysis in choice D may indicate an arterial steal syndrome, but it is not a medical emergency, and the client can be instructed to follow up with the provider. Therefore, the correct answer is choice B.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
The correct answer is Choice D because, "Household contacts will receive prophylactic antibiotics." The nurse should include in the teaching that household contacts of the child with pertussis will receive prophylactic antibiotics to prevent the spread of the disease. This answer is correct because pertussis is a highly contagious respiratory illness that spreads through respiratory droplets, and prophylactic antibiotics can help prevent the spread of the disease.
Choice A is wrong because is incorrect because a dehumidifier will not prevent the spread of pertussis.
Choice B is wrong because is incorrect because pertussis does not cause a rash.
Choice C is wrong because is incorrect because herd immunity occurs when a large percentage of the population is immunized against a disease, and pertussis is preventable with vaccination.
Correct Answer is C
Explanation
Choice A is wrong because, "An adolescent who has scoliosis," Severe scoliosis may require treatment, such as a brace or surgery, but in general, scoliosis is not an acute health emergency. Early detection can help manage the condition effectively, but it is not a priority over more urgent health concerns.
Choice B is wrong because, "An adolescent who has psoriasis," is not the correct answer as it is not an urgent health issue that requires immediate attention.
Choice C is correctbecause, "A child who has nits," Nits are the eggs of lice, which are tiny parasitic insects that infest the scalp, causing itching and discomfort. While head lice infestation can be a nuisance, it is generally not dangerous. However, it is highly contagious, especially in a school setting, and can spread rapidly among children.
Choice D is wrong because, "A child who has a BMI of 18," is also not the correct answer as while it is important to address, it is not an urgent health issue that requires immediate attention.
Whether you are a student looking to ace your exams or a practicing nurse seeking to enhance your expertise , our nursing education contents will empower you with the confidence and competence to make a difference in the lives of patients and become a respected leader in the healthcare field.
Visit Naxlex, invest in your future and unlock endless possibilities with our unparalleled nursing education contents today
Report Wrong Answer on the Current Question
Do you disagree with the answer? If yes, what is your expected answer? Explain.
Kindly be descriptive with the issue you are facing.