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Patient Data

Exhibits
The healthcare provider initiates prescriptions.
Select the additional 4 questions the nurse should include in the assessment.

Does the toddler experience choking or gagging after eating?

Has the toddler been treated for these symptoms before?

Does the toddler follow a strict daily routine?

Does the toddler attend daycare?

Does the toddler eat table food?

Does smoking occur in the home?

Answer and Explanation

Correct Answer : A,B,D,F

Rationale:

A. Does the toddler experience choking or gagging after eating?: Asking about choking or gagging helps identify possible swallowing difficulties or risk of aspiration, which may complicate upper respiratory infections.

B. Has the toddler been treated for these symptoms before?: Knowing prior treatments or recurrent infections provides context for chronicity, helps identify resistant infections, and guides current care decisions.

C. Does the toddler follow a strict daily routine?: While routines affect behavior and sleep, this information is not directly relevant to assessing the current respiratory illness or risk factors.

D. Does the toddler attend daycare?: Attendance at daycare increases exposure to infectious agents and helps evaluate risk for contagious illness or recurrent upper respiratory infections.

E. Does the toddler eat table food?: Diet details are not immediately relevant to the acute assessment of respiratory symptoms and infection risk.

F. Does smoking occur in the home?: Exposure to secondhand smoke increases the risk of respiratory infections and may exacerbate symptoms, making it an important factor in assessment.

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Free Nursing Study Resources

Correct Answer is C

Explanation

Rationale:

A. Assess deep tendon reflexes (DTRs) every 4 hours: Monitoring DTRs is essential to detect early signs of magnesium toxicity, but the frequency of assessment alone does not immediately prevent life-threatening complications.

B. Provide a quiet environment with subdued lighting: A calm environment helps reduce maternal stress and may support labor progression, but it does not address the primary safety concern associated with magnesium sulfate therapy.

C. Have calcium gluconate immediately available: Calcium gluconate is the antidote for magnesium sulfate toxicity. Having it readily available is the highest priority because magnesium toxicity can rapidly depress neuromuscular and respiratory function, requiring immediate intervention.

D. Insert an indwelling urinary catheter with a urimeter to monitor hourly output: Monitoring urine output is important to assess renal function and magnesium excretion, but immediate availability of the antidote takes precedence in preventing life-threatening complications.

A. Situate in knee-chest position. B. Perform chest physiotherapy. C. Reduce flow rate of intravenous fluid replacement. D. Administer prescribed morphine subcutaneously.

Correct Answer is A

Explanation

Rationale:

A. Situate in knee-chest position: Placing the infant in a knee-chest position increases systemic vascular resistance, which helps reduce right-to-left shunting and improves pulmonary blood flow during a hypercyanotic (“Tet”) spell to improve oxygenation and prevent hypoxic injury.

B. Perform chest physiotherapy: Chest physiotherapy is used to mobilize secretions in respiratory conditions but does not address the acute pathophysiology of a Tet spell. It would not rapidly improve oxygenation in this emergency.

C. Reduce flow rate of intravenous fluid replacement: Reducing IV fluids may decrease venous return but does not relieve the hypoxic crisis caused by right-to-left shunting. This intervention is not indicated during a hypercyanotic episode.

D. Administer prescribed morphine subcutaneously: Morphine can be used to calm the infant and reduce pulmonary resistance in some Tet spell protocols, but positioning the infant in a knee-chest posture is the first, immediate action to improve oxygenation before pharmacologic measures.

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Patient Data Exhibits The healthcare provider initiates prescriptions. Select the additional 4 questions the nurse should include in the assessment.

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The nurse is preparing to administer magnesium sulfate to a laboring client whose blood pressure has increased from 110/60 mm Hg to 140/90 mm Hg. Which nursing protocol has the highest priority?

Correct Answer is C

Explanation

The nurse is caring for an infant with tetralogy of Fallot. During a blood draw the nurse observes the infant becoming pale and lethargic with circumoral cyanosis and diminished peripheral pulses. Which action should the nurse take next?

Correct Answer is A

Explanation

Patient Data Exhibits Which findings indicate an improvement in the client’s condition?

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Patient Data

Exhibits
The healthcare provider initiates prescriptions.
Select the additional 4 questions the nurse should include in the assessment.