A nurse is caring for a preschooler immediately following a tonsillectomy and notices the child swallowing frequently.
Which of the following actions should the nurse take?

Check the back of the throat with a pen light.

Obtain the child’s vital signs in 15 min.

Administer analgesia.

Offer the child a drink of water.

Answer and Explanation

The Correct Answer is C

Administer analgesia. The child is likely experiencing pain and discomfort after the tonsillectomy, which can cause frequent swallowing. Analgesia can help relieve the pain and reduce the risk of bleeding.

Choice A is wrong because checking the back of the throat with a pen light can cause trauma and bleeding to the surgical site. The nurse should avoid using any instruments or objects in the mouth of the child after a tonsillectomy.

Choice B is wrong because obtaining the child’s vital signs in 15 min is not a priority action. The nurse should monitor the child’s vital signs more frequently, especially for signs of bleeding such as increased pulse and decreased blood pressure.

Choice D is wrong because offering the child a drink of water can cause irritation and bleeding to the throat. The nurse should avoid giving the child any fluids or foods by mouth until the gag reflex returns and the child is fully awake. The nurse should also avoid giving the child any fluids or foods that are acidic, carbonated, hot, or spicy, as they can cause pain and bleeding.

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Correct Answer is D

Explanation

Insulin lispro was administered to a client immediately before bed. This is a situation that requires the completion of an incident report because insulin lispro is a rapid-acting insulin that should be given within 15 minutes before or after a meal. Giving it immediately before bed can cause hypoglycemia (low blood sugar) during the night, which can be dangerous for the client.

Choice A is wrong because nitroglycerin transdermal is a medication used to prevent angina (chest pain) and can be applied to a client’s chest as prescribed.

Choice B is wrong because cefotaxime is an antibiotic that can be administered to a client after obtaining blood cultures to treat an infection.

Choice C is wrong because digoxin is a medication used to treat heart failure and atrial fibrillation and can be administered to a client who has a heart rate of 64/min, which is within the normal range of 60 to 100 beats per minute.

A. History of exercise-induced asthma. B. Age 35 years. C. History of mumps. D. BMI 32.2.

Correct Answer is D

Explanation

BMI 32.2.

A high body mass index (BMI) is a major risk factor for type 2 diabetes mellitus, as it indicates overweight or obesity.

Overweight or obesity can cause insulin resistance, which means the body cells do not respond well to insulin and cannot take up glucose from the blood. This leads to high blood sugar levels and diabetes.

Choice A is wrong because history of exercise-induced asthma is not a risk factor for type 2 diabetes mellitus.

Asthma is a respiratory condition that causes inflammation and narrowing of the airways, but it does not affect the metabolism of glucose or insulin.

Choice B is wrong because age 35 years is not a risk factor for type 2 diabetes mellitus.

Although the risk of diabetes increases with age, especially after 45 years, it can also occur in younger people.

Age alone is not enough to cause diabetes.

Choice C is wrong because history of mumps is not a risk factor for type 2 diabetes mellitus.

Mumps is a viral infection that affects the salivary glands, but it does not damage the pancreas or impair insulin production.

Some other risk factors for type 2 diabetes mellitus are family history, race or ethnicity, physical inactivity, prediabetes, gestational diabetes, polycystic ovarian syndrome, and smoking.

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A nurse is caring for a preschooler immediately following a tonsillectomy and notices the child swallowing frequently. Which of the following actions should the nurse take?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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Correct Answer is D

Explanation

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Explanation

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A nurse is caring for a preschooler immediately following a tonsillectomy and notices the child swallowing frequently.
Which of the following actions should the nurse take?