Nokea
A client has a new prescription for nitroglycerin sublingual tablets. Which of the following instructions should the nurse include?
- A. Take the medication with food.
- B. Place the tablet under your tongue and let it dissolve completely.
- C. Swallow the tablet whole with a glass of water.
- D. Chew the tablet for faster relief.
Correct Answer: B
Rationale: The correct instruction for a client prescribed nitroglycerin sublingual tablets is to place the tablet under the tongue and let it dissolve completely. This route of administration allows for rapid absorption of the medication through the oral mucosa, providing quick relief for angina symptoms. Option A, taking the medication with food, is incorrect as nitroglycerin should be taken sublingually, not with food. Option C, swallowing the tablet whole with water, is incorrect as sublingual tablets should not be swallowed whole. Option D, chewing the tablet for faster relief, is also incorrect as chewing the tablet can lead to rapid absorption and potential adverse effects rather than a controlled release for angina relief.
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When caring for a client at the end of life, which statement by the client's partner reflects effective coping?
- A. I am relying on support from our family during this time.
- B. I am feeling overwhelmed but don't want to talk about it.
- C. I am managing everything on my own without help.
- D. I prefer to stay alone with my partner.
Correct Answer: A
Rationale: The correct answer is A: 'I am relying on support from our family during this time.' When a client is at the end of life, relying on support from family can be an effective coping mechanism. It allows the partner to share the emotional burden, seek comfort, and prevent feelings of isolation. Choice B reflects a reluctance to express feelings, which can hinder coping mechanisms by internalizing stress. Choice C suggests handling everything alone, which can lead to burnout and emotional strain due to the overwhelming responsibilities. Choice D, preferring to stay alone with the partner, may limit access to external support that could provide additional emotional and practical assistance during this challenging time, making it a less effective coping strategy.
During a blood transfusion, which observation indicates that the client is experiencing a transfusion reaction?
- A. The client reports feeling warm and flushed.
- B. The client develops a rash on the chest and back.
- C. The client experiences chills and a fever.
- D. The client complains of back pain and shortness of breath.
Correct Answer: D
Rationale: Complaints of back pain and shortness of breath are classic signs of a transfusion reaction, specifically indicating a hemolytic reaction. This reaction can lead to the release of hemoglobin into the bloodstream, causing back pain and shortness of breath due to clot formation in the blood vessels, leading to decreased oxygen delivery. Warmth, flushing, rash, chills, and fever are more commonly associated with allergic reactions or febrile non-hemolytic reactions during transfusions. Therefore, options A, B, and C are incorrect in this context.
A client with a history of atrial fibrillation is receiving warfarin (Coumadin). Which laboratory value should the LPN/LVN monitor closely while the client is taking this medication?
- A. Blood glucose level
- B. Prothrombin time (PT) and INR
- C. Serum potassium level
- D. Serum creatinine level
Correct Answer: B
Rationale: The LPN/LVN should closely monitor Prothrombin time (PT) and INR (Choice B) levels in a client receiving warfarin. These values are crucial to ensure the medication's effectiveness and prevent complications like bleeding. Monitoring blood glucose level (Choice A) is not directly relevant to warfarin therapy. While serum potassium level (Choice C) and serum creatinine level (Choice D) are important for other conditions or medications, they are not specifically required to be monitored when a client is on warfarin.
A nurse is providing home care for a client who is receiving tube feedings and medication through a gastrostomy tube. The family member providing the feedings reports that the client has begun to have diarrhea. For which of the following practices should the nurse intervene?
- A. The family member washes out the feeding bag with warm water once every 24 hours.
- B. The family member washes out the feeding bag with hot water once every 24 hours.
- C. The family member washes out the feeding bag with soap and water every 24 hours.
- D. The family member changes the feeding bag every 24 hours.
Correct Answer: A
Rationale: The correct answer is A. Washing out the feeding bag with warm water once every 24 hours is not sufficient to prevent bacterial growth and can lead to diarrhea. Using hot water may damage the feeding bag. Washing out the feeding bag with soap and water every 24 hours is excessive and may leave residue that could be harmful. Changing the feeding bag every 24 hours is important for preventing infections but does not directly address the issue of diarrhea in this case.
When performing nasotracheal suctioning for a client with a respiratory infection, what technique should the nurse use?
- A. Apply intermittent suction when withdrawing the catheter
- B. Suction continuously while inserting the catheter
- C. Suction intermittently while inserting the catheter
- D. Use a Yankauer suction device
Correct Answer: A
Rationale: When performing nasotracheal suctioning for a client with a respiratory infection, the nurse should apply intermittent suction when withdrawing the catheter. This technique helps minimize mucosal damage and is considered best practice. Choice B, suctioning continuously while inserting the catheter, is incorrect as continuous suctioning can cause trauma to the airway. Choice C, suctioning intermittently while inserting the catheter, is also incorrect as it can increase the risk of hypoxia and mucosal damage. Choice D, using a Yankauer suction device, is not appropriate for nasotracheal suctioning as it is typically used for oral suctioning. Therefore, the correct technique is to apply intermittent suction when withdrawing the catheter to ensure effective and safe suctioning.