A mother calls the clinic to report problems with her baby. The baby was vaccinated earlier in the day. Which of the following concerns is not considered routine?
a. The baby is decreasingly responsive
b. The baby cried for 1 hour
c. The baby had a seizure
d. Both A and C
D
It is normal for a baby to cry for a couple of hours after a vaccination. The other signs are not normal and necessitate immediate attention.
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With delegation, responsibility and accountability remain with the:
a. Physician. b. Professional who delegates. c. Individual who receives the delegation. d. Individual who previously performed the task.
The nurse is caring for a client with otitis media and notes purulent drainage in the ear canal during the physical assessment. Which is the nurse's priority intervention?
a. Obtain a specimen of the drainage for culture. b. Irrigate the ear canal with sterile normal saline. c. Gently examine the client's ear with an otoscope. d. Place a cotton ball in the ear canal to ab-sorb the drainage.
Which order should the nurse question when caring for a child after surgery for Hirschsprung's disease?
a. Monitor rectal temperature every 4 hours and report an elevation greater than 38.5° C. b. Assess stools after surgery. c. Keep the child NPO until bowel sounds return. d. Maintain IV fluids at an ordered rate.
The nurse is preparing a comatose client for oral hygiene. Unless contraindicated, the best posi-tion to place the client in is:
1. Sims' 2. Dorsal recumbent 3. Prone 4. Fowlers