Nokea
A nurse is preparing to administer an intramuscular injection to an adult client. At what angle should the nurse administer the medication using the ventrogluteal site?
- A. a 45-degree angle
- B. a 60-degree angle
- C. a 75-degree angle
- D. a 90-degree angle
Correct Answer: D
Rationale: Intramuscular injections in the ventrogluteal site should be administered at a 90-degree angle. This angle ensures that the medication reaches the muscle tissue effectively. Angles less than 90 degrees can cause subcutaneous injection instead of intramuscular, leading to slower absorption of the medication. Angles greater than 90 degrees risk hitting bone or nerves, causing unnecessary pain or injury. Therefore, the correct angle for administering intramuscular injections in the ventrogluteal site is 90 degrees.
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A healthcare provider is preparing to administer a measles, mumps, and rubella (MMR) vaccine to an adult client. Which of the following is a contraindication to this vaccine?
- A. The possibility of pregnancy within 4 weeks
- B. Client allergy to strawberries
- C. Client history of genital herpes
- D. The possibility of overseas travel in the next month
Correct Answer: A
Rationale: The correct answer is A. Pregnancy or the possibility of pregnancy within 4 weeks is a contraindication for receiving the MMR vaccine. Choice B, client allergy to strawberries, is not a contraindication to the MMR vaccine. Choice C, client history of genital herpes, is not a contraindication for the MMR vaccine. Choice D, the possibility of overseas travel in the next month, is not a contraindication to the MMR vaccine.
A nurse is caring for a client receiving theophylline for chronic obstructive pulmonary disease (COPD). Which of the following client findings indicates the need for immediate intervention?
- A. Productive cough
- B. Drowsiness
- C. Vomiting
- D. Polyuria
Correct Answer: D
Rationale: Polyuria is a sign of theophylline toxicity and requires immediate intervention. Theophylline toxicity can lead to serious complications, and polyuria is a concerning symptom that indicates the need for urgent medical attention. Productive cough, drowsiness, and vomiting are common side effects of theophylline but are not typically indicative of immediate life-threatening issues like polyuria in the context of theophylline toxicity.
A 45-year-old client is taking methylprednisolone. What pharmacologic action should the nurse expect with this therapy?
- A. Suppression of beta2 receptors
- B. Suppression of airway mucus production
- C. Fortification of bones
- D. Suppression of candidiasis
Correct Answer: B
Rationale: The correct answer is B: Suppression of airway mucus production. Corticosteroids like methylprednisolone are known to suppress airway mucus production. This action helps in reducing inflammation and swelling in the airways, making breathing easier for individuals with conditions like asthma or COPD. Choices A, C, and D are incorrect. Suppression of beta2 receptors is more related to beta-blockers, fortification of bones is associated with medications like bisphosphonates, and suppression of candidiasis is not a typical pharmacologic action of methylprednisolone.
A client is receiving chemotherapy and develops stomatitis. Which of the following interventions should the nurse include in the client's plan of care?
- A. Apply warm compresses to the mouth
- B. Rinse mouth with alcohol-free mouthwash
- C. Increase fluid intake
- D. Clean the mouth gently with a soft toothbrush after meals
Correct Answer: A
Rationale: The correct answer is to apply warm compresses to the mouth. Stomatitis is an inflammation of the mucous lining in the mouth and can be a side effect of chemotherapy. Warm compresses can help soothe the affected area and promote healing. Choice B is incorrect because alcohol-based mouthwash can further irritate the mouth. Choice C is also a good intervention as increasing fluid intake can help keep the mouth moist and promote healing. However, the most direct intervention for soothing and healing the affected area is applying warm compresses. Choice D is incorrect because using a firm toothbrush can be too harsh and cause further irritation.
A 52-year-old client with a history of angina has been prescribed transdermal nitroglycerin. Which of the following adverse effects is not associated with this therapy?
- A. Tolerance
- B. Orthostatic hypotension
- C. Headache
- D. Productive cough
Correct Answer: D
Rationale: The correct answer is D: Productive cough. Nitroglycerin therapy can lead to adverse effects such as tolerance, orthostatic hypotension, and headache. However, it is not known to cause a productive cough. Tolerance may develop over time, requiring dose adjustments. Orthostatic hypotension can occur due to vasodilation effects, leading to a sudden drop in blood pressure when changing positions. Headache is a common side effect due to vasodilation of cranial blood vessels. Productive cough is not a recognized adverse effect associated with transdermal nitroglycerin therapy.