Nokea
The nurse is reinforcing teaching with a client who had a total knee replacement and has a new prescription for enoxaparin. Which of the following information should the nurse reinforce?
- A. Mild bruising or redness may occur at the injection site.
- B. Eliminate green, leafy, vitamin K-rich vegetables from your diet.
- C. Black stools are a common, harmless adverse effect of the medication.
- D. Take over-the-counter medications such as ibuprofen to relieve mild discomfort.
Correct Answer: A
Rationale: Mild bruising or redness is an expected side effect of enoxaparin. Black stools indicate possible bleeding, and ibuprofen increases bleeding risk. Vitamin K restriction is not necessary.
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An adolescent client is admitted in respiratory alkalosis following aspirin overdose. The nurse recognizes that this imbalance was caused by
- A. Tachypnea
- B. Acidic byproducts
- C. Aspirin poisoning and dehydration
- D. Hyperpyrexia
Correct Answer: A
Rationale: Tachypnea. Stimulation of respiratory center leads to hyperventilation, thus decreasing CO2 levels which causes respiratory alkalosis.
A client with methicillin-resistant Staphylococcus aureus (MRSA) bacteremia has been receiving IV vancomycin for the last 3 days. Which blood test trend is most important for the nurse to review when preparing to administer this medication?
- A. Blood cultures
- B. Creatinine levels
- C. Magnesium levels
- D. White blood cell (WBC) count
Correct Answer: B
Rationale: Vancomycin can cause nephrotoxicity, so monitoring creatinine levels is critical to assess kidney function.
Which of the following medications is not considered a neuromuscular blocker?
- A. Anectine
- B. Pavulon
- C. Pitressin
- D. Mivacron
Correct Answer: C
Rationale: Pitressin is a hormone replacement medication.
The nurse is caring for several clients. When thinking about long-term goals, the nurse knows that which of these clients has the best prognosis?
- A. A young adult who has stage I Hodgkin's lymphoma
- B. A young adult who has leukemia
- C. A young adult who has osteosarcoma
- D. A 50-year-old who has multiple myeloma
Correct Answer: A
Rationale: Stage I Hodgkin's lymphoma has a high cure rate (over 90%) with treatment, offering the best prognosis compared to leukemia, osteosarcoma, or multiple myeloma.
The nurse is caring for a client who had a surgical excision and biopsy of a tumor. The biopsy results show that the tumor is malignant, but the client has not yet been informed by the health care provider. The client asks the nurse, 'Am I going to die?' Which of the following responses would be appropriate for the nurse to make?
- A. You seem upset. Tell me more about how you are feeling about this situation.
- B. I understand that you feel anxious. Maybe watching television will help you relax.
- C. Waiting for test results can be very stressful. I am sure that it will all work out.
- D. The biopsy results show that you have cancer. However, many cancers are treatable.
Correct Answer: A
Rationale: Exploring the client's feelings is supportive and appropriate, as the nurse should not disclose results before the provider.