100 Item Comprehensive Exam With Answers And Rationale

100 item Comprehensive Exam with Answers and Rationale1. The nurse enters the room as a 3 year-old is having a generalized seizure. Which intervention should the nurse do first?A) Clear the area of any hazardsB) Place the child on the sideC) Restrain the childD) Give the prescribed anticonvulsantThe correct answer is B: Place the child on the sideProtecting the airway is the top priority in a seizure. If a child is actively convulsing, a patentairway and oxygenation must be assured.2. A client has just returned to the medical-surgical unit following a segmental lung resection. After assessing the client, the first nursing action would be toA) Administer pain medicationB) Suction excessive tracheobronchial secretionsC) Assist client to turn, deep breathe and coughtD) Monitor oxygen saturationThe correct answer is B: Suction excessive tracheobronchial secretionsSuctioning the copious tracheobronchial secretions present in post-thoracic surgery clients maintains an open airway which is always the priority nursing intervention.3. A nurse from the surgical department is reassigned to the pediatric unit. The charge nurseshould recognize that the child at highest risk for cardiac arrest and is the least likely to be assiged to this nurse is which child?A) Congenital cardiac defectsB) An acute febrile illnessC) Prolonged hypoxemiaD) Severe