Nokea
A 2-year-old who swallowed an overdose of adult cough syrup is being discharged from the emergency department. The parent says to the nurse, 'From now on, I'm going to store all medicines in my top dresser drawer.' Which is the best response by the nurse?
- A. Can you lock your dresser drawer?
- B. Make sure all of your medicines have childproof caps.
- C. That sounds like a safe plan.
- D. You need to keep an eye on your child at all times.
Correct Answer: A
Rationale: A locked drawer (A) ensures safety. Childproof caps (B) are helpful but insufficient alone. The plan (C) is unsafe without a lock, and constant supervision (D) is unrealistic.
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Before giving furosemide (Lasix) to an adult, the nurse checks the laboratory report for the last serum potassium level. Which finding would be of concern to the nurse?
- A. 3.2 mEq/L
- B. 3.7 mEq/L
- C. 4.1 mEq/L
- D. 4.9 mEq/L
Correct Answer: A
Rationale: A potassium level of 3.2 mEq/L is low, concerning with furosemide, which can further deplete potassium, risking arrhythmias.
The best position for the client with a right total hip replacement is:
- A. With the right hip flexed 90°
- B. With the right hip flexed 35°
- C. Supine with pillows supporting the right leg
- D. Sims position with the right leg adducted
Correct Answer: C
Rationale: Supine with pillows supporting the leg prevents dislocation while maintaining alignment. Flexion or adduction risks complications.
The nurse is teaching a client newly diagnosed with asthma how to use the metered-dose inhaler (MDI). The client asks when they will know the canister is empty. The best response is
- A. Drop the canister in water to observe floating
- B. Estimate how many doses are usually in the canister
- C. Count the number of doses as the inhaler is used
- D. Shake the canister to detect any fluid movement
Correct Answer: A
Rationale: Dropping the canister into a bowl of water assesses the amount of medication remaining in a metered-dose inhaler. The client should obtain a refill when the inhaler rises to the surface and begins to tip over.
The intensive care nurse is caring for a client who has just been extubated. Which interventions are appropriate at this time?
- A. Administer prescribed oral narcotics for throat pain
- B. Administer warmed, humidified oxygen via facemask
- C. Give the client ice chips to moisten the mouth
- D. Provide mouth care with oral sponges
- E. Start the client on incentive spirometer
Correct Answer: B,C,D,E
Rationale: Post-extubation, warmed, humidified oxygen (B) prevents mucosal drying, ice chips (C) moisten the mouth, oral sponges (D) maintain hygiene, and incentive spirometry (E) promotes lung expansion. Oral narcotics (A) are risky due to potential airway compromise.
The physician orders lisinopril (Zestril) and furosemide (Lasix) to be administered concomitantly to the client with hypertension. The nurse should:
- A. Question the order.
- B. Administer the medications.
- C. Administer them separately.
- D. Contact the pharmacy.
Correct Answer: B
Rationale: Lisinopril and furosemide are commonly prescribed together for hypertension, as lisinopril is an ACE inhibitor that reduces blood pressure, and furosemide is a diuretic that reduces fluid volume. There is no contraindication for administering them concomitantly, so answer A is incorrect. Administering them separately is unnecessary, so answer C is incorrect. Contacting the pharmacy is not needed unless there is a supply issue, so answer D is incorrect.