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Question 1 of 5.

A mother brings her 1-month-old son to the clinic for a well-baby visit. The child has a moderately severe hypospadias that was seen by a urologist in the newborn nursery. The mother is upset that the doctors would not circumcise her son before he was discharged. What information should the nurse include when responding to the mother?

A. The foreskin should not be removed because it will be used in the repair of the hypospadias.

B. The child's condition did not allow for elective surgery. It will be done at a later date when he is stronger.

C. Circumcision is a surgical procedure. Because he will have surgery in the near future, it will be done at the same time to avoid two surgeries close together.

D. The procedure was not done because circumcision is medically unnecessary, not because he has a hypospadias.

Explanation: Hypospadias repair often uses foreskin tissue, so circumcision is avoided to preserve it for surgical correction, addressing the mother's concern.

Question 2 of 5.

The nurse is to change a dressing. Which is essential to do when opening the dressing set?

A. Open the first flap away from the nurse.

B. Open the first flap toward the nurse.

C. Place the dressing set on a chair beside the bed.

D. Place the dressing set on the client's bed.

Explanation: The first flap should be opened away from the nurse to allow the last flap to be opened toward the nurse, preventing contamination. The dressing set should be placed at waist height on a clean surface like an overbed table, not on the bed or a chair.

Question 3 of 5.

A young adult is admitted to the psychiatric unit because she has become very withdrawn and has stopped attending college classes. She sits for hours rocking back and forth and appears to be talking to someone at intervals. She does not eat or bathe or relate to others. How should the nurse approach this client upon admission?

A. Explain the unit routines to her in detail

B. Ask her if she has any question about the unit or what she is supposed to do

C. Briefly explain the most essential information and then sit with her

D. Take her by the hand and orient her to the unit

Explanation: A withdrawn client may be overwhelmed by detailed explanations. Brief information and quiet presence build trust and reduce anxiety.

Question 4 of 5.

A 1-year-old boy is hospitalized for a fractured femur. There is a PRN order for pain medication. What is the best way to assess the child for pain?

A. Ask the parent who is present if the child appears to be in pain.

B. Observe the child's behavior carefully.

C. Ask the child where it hurts and how badly it hurts.

D. Have the child look at pictures of faces and select the one that best describes how he feels right now.

Explanation: A 1-year-old cannot verbalize pain; observing behavior (e.g., crying, guarding) is the most reliable pain assessment method.

Question 5 of 5.

A client is to be discharged on enoxaparin (Lovenox) for the next two days. Which comment by the client indicates a need for further instruction?

A. I will wash my hands before I prepare the injection.

B. I will give the injection in my thigh.

C. I will pinch the skin before I inject the medicine.

D. I will not massage the area after the shot.

Explanation: Enoxaparin is injected subcutaneously in the abdomen, not the thigh, indicating a need for further teaching.

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