Nokea
A teenage client is admitted to the hospital because of acetaminophen (Tylenol) overdose. Overdoses of acetaminophen can precipitate life-threatening abnormalities in which of the following organs?
- A. lungs
- B. liver
- C. kidneys
- D. adrenal glands
Correct Answer: B
Rationale: Acetaminophen is extensively metabolized in the liver. Choices A, C, and D are incorrect because prolonged use of acetaminophen might result in an increased risk of renal dysfunction, but a single overdose does not precipitate life-threatening problems in the respiratory system, renal system, or adrenal glands.
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Metformin (Glucophage) is administered to clients with type II diabetes mellitus. Metformin is an example of:
- A. an antihyperglycemic agent.
- B. a hypoglycemic agent.
- C. an insulin analogue.
- D. a pancreatic alpha cell stimulant.
Correct Answer: A
Rationale: This antihyperglycemic agent prevents hyperglycemia by reducing hepatic glucose output and decreasing glucose absorption from the gut. A hypoglycemic drug stimulates insulin production. Metformin is not a type of insulin. Metformin is not a stimulant of any pancreatic cell.
A day care center has asked the nurse to provide education for parents regarding safety in the home. What type of preventive care does this represent?
- A. primary
- B. secondary
- C. tertiary
- D. health promotion
Correct Answer: A
Rationale: Primary prevention involves activities that are utilized to promote wellness or prevent illness or injury. There are many dangers in the home for small children. Providing education regarding the need for safety measures to prevent injury in the home is considered primary prevention. Secondary prevention involves early detection of a disease or illness and quick intervention to aid the client in maintenance of the disease or injury. Tertiary prevention involves the reduction of a disability and the promotion of the highest level of functioning for a client in relation to his or her disease or injury. Health promotion is any activity that increases a client's health and wellness.
A nurse doing a home health visit consults with a male patient that has a diagnosis of CAD and COPD. The patient is currently taking Ventolin, Azmacort, Aspirin, and Theophylline. The patient complains of upset stomach, nausea and feeling uncomfortable. The nurse should:
- A. Contact the patient's physician immediately.
- B. Recommend the patient position himself in right sidelying.
- C. Recommend the patient schedule a doctor's visit the next day.
- D. Recommend a hold on the drug-Azmacort.
Correct Answer: A
Rationale: Consult the physician immediately, due to the fact that theophylline toxicity may be occurring.
A client's central venous access device (CVAD) becomes infected. Why might the physician order antibiotics to be given through the line rather than through a peripheral IV line?
- A. to prevent infiltration of the peripheral line
- B. to reduce the pain and discomfort associated with antibiotic administration in a small vein
- C. to lessen the chance of an allergic reaction to the antibiotic
- D. to attempt to eliminate microorganisms in the catheter and prevent having to remove it
Correct Answer: D
Rationale: Microorganisms that infect CVADs are often coagulase-negative staphylococci, which can be eliminated by antibiotic administration through the catheter. If unsuccessful in eliminating the microorganism, the CVAD must be removed. CVAD use lessens the need for peripheral IV lines and thus the risk of infiltration. In this case, however, the antibiotics are given to eradicate microorganisms from the CVAD. CVAD use has the effect described in Choice 2, but in this case, the antibiotics are given through the CVAD to eliminate the infective agent. The route does not prevent an allergic reaction.
When teaching a woman about possible side effects of hormone replacement therapy, the nurse should include information about all of the following except:
- A. Hypoglycemia in diabetic women.
- B. The possible return of monthly menses when taking combination hormones.
- C. Increased risk of gallbladder disease.
- D. Increased risk of breast, cervical, and ovarian cancer with long-term use.
Correct Answer: A
Rationale: When taking estrogen, there is an increased risk of diabetes or hyperglycemia due to lowered glucose tolerance. It is true that monthly menses might return when taking combination hormones. The progestin is responsible for this. There is also a risk of gallbladder disease. It is also true that there is an increased risk of breast, cervical, and ovarian cancer with long-term hormone replacement therapy.