- (Topic 7)
A 4-year-old boy is brought to the emergency room with bruises on his head, face, arms, and legs. His mother states that he fell down some steps. The nurse suspects that he may have been physically abused. In accordance with the law, the nurse must:

1. A. Tell the physician her concerns
2. B. Report her suspicions to the authorities
3. C. Talk to the child??s father
4. D. Confront the child??s mother

Correct Answer: B
(A) Although the nurse probably would talk to the physician about these concerns, the nurse is not required by law to do so. (B) All healthcare workers are required by the Federal Child Abuse Prevention and Treatment Act of 1974 to report suspected and actual cases of child abuse and/or neglect. (C) Talking to the child??s father may or may not help the child, and the nurse is not required by law to do so. (D) Confrontation may not be indicated; the nurse is not required by law to confront the child??s mother with these suspicions.

- (Topic 4)
As a postoperative cholecystectomy client completes tomorrow??s dinner menu, the nurse knows that one of the following meal choices will best provide the essential vitamin(s) necessary for proper tissue healing?

1. A. Liver, white rice, spinach, tossed salad, custard pudding
2. B. Fish fillet, carrots, mashed potatoes, butterscotch pudding
3. C. Roast chicken, gelatin with sliced fruit
4. D. Chicken breast fillet in tomato sauce, potatoes, mustard greens, orange and strawberry slices

Correct Answer: D
(A) This meal choice provides more of the vitamins A, D, and K than of vitamin C. (B) This meal choice provides more of the vitamins A, B12, and D than of vitamin C. (C) This meal choice provides more of the vitamins A, B1 (thiamine), niacin, and microminerals than of vitamin C. (D) This meal choice provides foods rich in vitamin C, which are essential in tissue healing.

- (Topic 1)
Proper positioning for the child who is in Bryant??s traction is:

1. A. Both hips flexed at a 90-degree angle with the knees extended and the buttocks elevated off the bed
2. B. Both legs extended, and the hips are not flexed
3. C. The affected leg extended with slight hip flexion
4. D. Both hips and knees maintained at a 90-degree flexion angle, and the back flat on the bed

Correct Answer: A
(A) The child??s weight supplies the countertraction for Bryant??s traction; the buttocks are
slightly elevated off the bed, and the hips are flexed at a 90-degree angle. Both legs are suspended by skin traction. (B) The child in Buck??s extension traction maintains the legs extended and parallel to the bed. (C) The child in Russell traction maintains hip flexion of the affected leg at the prescribed angle with the leg extended. (D) The child in ??90–90?? traction maintains both hips and knees at a 90-degree flexion angle and the back is flat on the bed.

- (Topic 1)
Pregnant women with diabetes often have problems related to the effectiveness of insulin in controlling their glucose levels during their second half of pregnancy. The nurse teaches the client that this is due to:

1. A. Decreased glomerular filtration and increased tubular absorption
2. B. Decreased estrogen levels
3. C. Decreased progesterone levels
4. D. Increased human placental lactogen levels

Correct Answer: D
(A) There is a rise in glomerular filtration rate in the kidneys in conjunction with decreased tubular glucose reabsorption, resulting in glycosuria. (B) Insulin is inhibited by increased levels of estrogen. (C) Insulin is inhibited by increased levels of progesterone. (D) Human placental lactogen levels increase later in pregnancy. This hormonal antagonist reduces insulin??s effectiveness, stimulates lipolysis, and increases the circulation of free fatty acids.

- (Topic 6)
The nurse has been caring for a 16-year-old female who recently experienced date rape. After having had crisis intervention and been hospitalized for 2 weeks, the nurse knows that the client is effectively coping with the rape when she tells the nurse:

1. A. ??I know it was my fault that it happened, because I shouldn??t have been out so late.??
2. B. ??If I had not worn that sexy dress that night, he wouldn??t have raped me.??
3. C. ??I know my date just had so much passion he couldn??t handle me saying ??no.?? ??
4. D. ??I know now that it was not my fault, but I want to continue counseling after my discharge.??

Correct Answer: D
(A) This response does not show any insight; the client falsely assumes that she is responsible for the rape. (B) The client continues to falsely assume responsibility for the rapist??s behavior. (C) The client believes falsely that rape is an act of passion, rather than one of violence, control, and domination. (D) The client has insight into the rape; she does not believe it was her fault and shows good judgment in deciding to continue with counseling after discharge.