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A client being discharged from the cardiac step-down unit following a myocardial infarction (MI), is given a prescription for a beta-blocking drug. A nursing student asks the charge nurse why this drug would be used by a client who is not hypertensive. What is an appropriate response by the charge nurse?
- A. Most people develop hypertension following an MI.'
- B. A beta-Blocker will prevent orthostatic hypotension.'
- C. This drug will decrease the workload on his heart.'
- D. Beta-blockers increase the strength of heart contractions.'
Correct Answer: C
Rationale: One action of beta-blockers is to decrease systemic vascular resistance by dilating arterioles. This is useful for the client with coronary artery disease, and will reduce the risk of another MI or sudden death.
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Convert 4 ounces to an equivalent amount in tablespoons.
- A. 6 Tbsp
- B. 8 Tbsp
- C. 12 Tbsp
- D. 1.33 Tbsp
Correct Answer: B
Rationale: 1 ounce = 2 tablespoons, so 4 ounces × 2 = 8 Tbsp. Other options are incorrect conversions.
A client comes to the emergency department complaining of headache, malaise, chills, fever, and a stiff neck. Vital sign assessment reveals a temperature elevation, increased heart and respiratory rates, and normal blood pressure. On physical examination, the nurse notes confusion, a petechial rash, nuchal rigidity, Brudzinski's sign, and Kernig's sign. What does Brudzinski's sign indicate?
- A. Increased intracranial pressure (ICP)
- B. Cerebral edema
- C. Low cerebrospinal fluid (CSF) pressure
- D. Meningeal irritation
Correct Answer: D
Rationale: Brudzinski's sign indicates meningeal irritation, as in meningitis. Other signs of meningeal irritation include nuchal rigidity and Kernig's sign. Brudzinski's sign doesn't indicate increased ICP, cerebral edema, or low CSF pressure.
The nurse should teach parents of small children that the most common type of first-degree burn is:
- A. scalding from hot bath water or spills.
- B. contact with hot surfaces such as stoves and fireplaces.
- C. contact with flammable liquids or gases resulting in flash burns.
- D. sunburn from lack of protection and overexposure.
Correct Answer: D
Rationale: Sunburn is the most common first-degree burn in children due to frequent sun exposure without adequate protection. Education on sunscreen use is critical. Safety and Infection Control
The patient's hostility created difficulties for the nursing staff.'
- A. The patient's rudeness prevented administration of his medications.'
- B. The patient threw the water pitcher across the room during shift change.'
- C. The patient's dressing change was interrupted by his belligerent behavior.'
Correct Answer: C
Rationale: Nursing documentation must be objective, describing specific actions without subjective judgments.
The nurse is preparing to administer a dose of enoxaparin (Lovenox) to a client with a pulmonary embolism. Which of the following actions should the nurse take?
- A. Administer the injection in the deltoid muscle.
- B. Massage the injection site after administration.
- C. Inject the medication subcutaneously in the abdomen.
- D. Dilute the medication with normal saline before injection.
Correct Answer: C
Rationale: Enoxaparin, a low-molecular-weight heparin, is administered subcutaneously in the abdomen (avoiding a 2-inch radius around the umbilicus) to ensure proper absorption. Deltoid injection (A) is incorrect, massaging (B) risks hematoma, and dilution (D) is unnecessary.