Nokea
A patient with severe anemia is prescribed erythropoietin. What is the primary action of this medication?
- A. Stimulate white blood cell production
- B. Increase platelet count
- C. Promote red blood cell production
- D. Enhance clotting factor production
Correct Answer: C
Rationale: The correct answer is C: Promote red blood cell production. Erythropoietin is a hormone that stimulates the bone marrow to produce more red blood cells, helping to treat anemia. It does not stimulate white blood cell production (A), increase platelet count (B), or enhance clotting factor production (D). White blood cells are involved in the immune response, platelets are responsible for clotting, and clotting factors are proteins involved in the blood clotting process. Therefore, the primary action of erythropoietin is to specifically target red blood cell production to address anemia.
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A client with cirrhosis is at risk for bleeding. Which laboratory test is most important to monitor?
- A. Blood glucose
- B. Serum creatinine
- C. Prothrombin time (PT)
- D. Electrolytes
Correct Answer: C
Rationale: The correct answer is C: Prothrombin time (PT). In cirrhosis, the liver's ability to produce clotting factors is impaired, leading to a higher risk of bleeding. Monitoring PT helps assess the liver's synthetic function and the blood's ability to clot. Abnormal PT values indicate a higher bleeding risk and guide interventions like vitamin K or blood products. Blood glucose (A), serum creatinine (B), and electrolytes (D) do not directly reflect the liver's synthetic function or clotting status in cirrhosis, making them less relevant for monitoring bleeding risk.
A client with a new diagnosis of myasthenia gravis is prescribed pyridostigmine (Mestinon). Which instruction should the nurse include in the client's teaching?
- A. Take the medication with food to prevent gastrointestinal upset.
- B. Take the medication 30 minutes before meals.
- C. Avoid dairy products while taking this medication.
- D. Take the medication at bedtime.
Correct Answer: B
Rationale: The correct answer is B: Take the medication 30 minutes before meals. Pyridostigmine is a cholinesterase inhibitor used to treat myasthenia gravis by improving muscle strength. Taking it before meals helps optimize its effects when muscle strength is needed the most during eating. Taking it with food (A) may delay absorption. Avoiding dairy products (C) is not necessary with pyridostigmine. Taking the medication at bedtime (D) may not be optimal for addressing muscle weakness during meal times.
The community health nurse is working in a multi-ethnic health center. In what situation should the nurse intervene?
- A. An Asian-American mother reports using cupping to treat infection, resulting in a pattern of red round marks on her toddler's back.
- B. A Hispanic pregnant client who is often late for appointments, arrives late for today's appointment.
- C. A Native-American who is being interviewed will not make direct eye contact when asked about violence in the home.
- D. An African-American infant who is spitting up milk has lost 6 ounces since last week's clinic visit.
Correct Answer: D
Rationale: The correct answer is D because an African-American infant losing weight rapidly is a sign of potential malnutrition or health issue that requires immediate intervention. The nurse should assess the infant's feeding, growth, and health status to address the problem promptly.
Choice A is incorrect as cupping is a cultural practice that may not necessarily harm the child and should be respected. Choice B is incorrect as being late for appointments is not a direct health risk that requires immediate intervention. Choice C is incorrect as avoiding direct eye contact is a cultural norm for some Native-American individuals and does not indicate a health emergency.
What is the primary action of a short-acting beta2-agonist (SABA) prescribed to a patient with an acute asthma exacerbation?
- A. Reduce inflammation
- B. Relieve bronchospasm
- C. Thin respiratory secretions
- D. Suppress cough
Correct Answer: B
Rationale: The correct answer is B: Relieve bronchospasm. Short-acting beta2-agonists (SABAs) like albuterol act by stimulating beta2 receptors in the airway smooth muscle, leading to bronchodilation and relieving bronchospasm. This helps to quickly open up the airways during an acute asthma exacerbation. Choice A is incorrect because SABAs do not directly reduce inflammation. Choice C is incorrect as SABAs do not affect respiratory secretions. Choice D is incorrect as SABAs do not suppress cough but rather target bronchospasm.
A client with type 1 diabetes mellitus is experiencing nausea and vomiting. What advice should the nurse give regarding insulin administration?
- A. Skip your insulin dose until you can eat.'
- B. Take your insulin as prescribed, but monitor your blood glucose closely.'
- C. Reduce your insulin dose by half.'
- D. Only take your long-acting insulin.'
Correct Answer: B
Rationale: The correct answer is B because skipping insulin can lead to dangerous complications like diabetic ketoacidosis. Taking insulin as prescribed ensures blood glucose control, preventing hyperglycemia. Monitoring blood glucose closely helps adjust doses accordingly. Choice A is incorrect as skipping insulin can be life-threatening. Choice C is incorrect as reducing insulin without proper monitoring can lead to unstable glucose levels. Choice D is incorrect as both long-acting and short-acting insulin are essential for managing type 1 diabetes.