Nokea
Before selecting which medication to administer, which action should the nurse implement if a postoperative client reports incisional pain and has two prescriptions for PRN analgesia?
- A. Compare the client's pain scale rating with the prescribed dosing.
- B. Determine which prescription will have the quickest onset of action.
- C. Ask the client to choose which medication is needed for the pain.
- D. Document the client's report of pain in the electronic medical record.
Correct Answer: A
Rationale: When a postoperative client reports incisional pain and has two prescriptions for PRN analgesia, the nurse should first compare the client's pain scale rating with the prescribed dosing. This action ensures that the client receives the appropriate medication based on their pain level. Determining the onset of action or asking the client to choose the medication does not guarantee that the right medication is administered according to the pain intensity. Documenting the pain report is important but should not be the first action when deciding which medication to administer.
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A client with Addison's disease started taking hydrocortisone in a divided daily dose last week. It is most important for the nurse to monitor which serum laboratory value?
- A. Osmolarity
- B. Glucose
- C. Albumin
- D. Platelets
Correct Answer: B
Rationale: The correct answer is B: Glucose. Hydrocortisone can lead to increased blood glucose levels, so monitoring glucose is crucial to assess for hyperglycemia, a common side effect of corticosteroid therapy. Monitoring osmolarity (choice A) is not typically indicated in this scenario. Albumin (choice C) and platelets (choice D) are not directly affected by hydrocortisone therapy and are not the primary focus of monitoring in this case.
A female client who was involved in a motor vehicle collision is admitted with a fractured left femur which is immobilized using a fracture traction splint in preparation for an open reduction internal fixation (ORIF). The nurse determines that her distal pulses are diminished in the left foot. Which interventions should the nurse implement? (Select all that apply)
- A. Verify pedal pulses using a doppler pulse device.
- B. Monitor left leg for pain, pallor, paresthesia, paralysis, pressure.
- C. Evaluate the application of the splint to the left leg.
Correct Answer: C
Rationale: It is crucial for the nurse to evaluate the application of the splint to the left leg in a client with diminished distal pulses. This assessment helps ensure that the splint is not causing any compromise to circulation. Verifying pulses and monitoring for leg conditions are important interventions but do not directly address the issue with the splint application in this scenario, making them less relevant.
The healthcare provider prescribes Cytovene 375 mg every 12 hours to infuse over 90 minutes. The pharmacy delivers Cytovene 375 mg in a 150 mL IV bag. How many ml/hour should the nurse program the infusion pump?
- A. 50 ml/hour.
- B. 75 ml/hour.
- C. 100 ml/hour.
- D. 125 ml/hour.
Correct Answer: C
Rationale: To infuse 150 mL over 90 minutes, the pump should be set to 100 ml/hour (150 mL / 1.5 hours). This rate ensures that the medication is delivered at the proper rate as prescribed. Choices A, B, and D are incorrect because they do not reflect the correct calculation based on the volume of the IV bag and the infusion duration provided in the question.
A client with peptic ulcer disease is prescribed sucralfate. What is the mechanism of action of this medication?
- A. Neutralizes stomach acid
- B. Decreases gastric acid secretion
- C. Covers the ulcer site and protects it from acid
- D. Improves gastric motility
Correct Answer: C
Rationale: The correct answer is C: Covers the ulcer site and protects it from acid. Sucralfate works by forming a protective barrier over ulcers, shielding them from stomach acid and promoting healing. Choice A, neutralizing stomach acid, is incorrect as sucralfate does not neutralize acid but acts as a physical barrier. Choice B, decreasing gastric acid secretion, is not the mechanism of action of sucralfate. Choice D, improving gastric motility, is unrelated to sucralfate's action on peptic ulcers.
Methotrexate is prescribed for a client with rheumatoid arthritis (RA) who is also taking aspirin. What is the best explanation for the nurse to provide as to why a second medication has been added?
- A. Methotrexate slows the disease progression while aspirin controls the symptoms.
- B. Methotrexate helps to reduce the side effects of aspirin.
- C. Methotrexate has fewer harmful side effects than aspirin.
- D. Methotrexate enhances the effect of aspirin.
Correct Answer: A
Rationale: The correct answer is A. Methotrexate is a disease-modifying antirheumatic drug (DMARD) that slows the progression of rheumatoid arthritis (RA), while aspirin helps control symptoms such as pain and inflammation. Therefore, the combination of methotrexate and aspirin is beneficial in managing RA by addressing both disease progression and symptom control. Choices B, C, and D are incorrect because methotrexate is not added to reduce the side effects of aspirin, has different side effects compared to aspirin, and does not enhance the effect of aspirin.