Nokea
A 35-year-old male patient is admitted to the hospital with pneumonia. He was originally being treated at home, but became worse when he quit taking his antibiotic prematurely. What is an appropriate nursing diagnosis for this patient?
- A. Deficient knowledge: monitoring temperature
- B. Noncompliance
- C. Risk for injury related to hypoxia
- D. Non-adherence: overuse
Correct Answer: B
Rationale: Stopping antibiotics early indicates noncompliance, worsening his condition.
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A 70-year-old patient has just received a drug that can cause sedation. What would be the priority nursing diagnosis for this patient?
- A. Noncompliance: Cost of the drug
- B. Deficient knowledge: Unfamiliar with drug therapy
- C. Risk for injury: Related to adverse effects of the drug
- D. Ineffective health maintenance: Need for medication
Correct Answer: C
Rationale: Sedation increases the risk of falls or injury, making 'Risk for injury' the priority diagnosis over knowledge deficits or compliance issues.
The patient has a diagnosis of multiple sclerosis and is taking the drug interferon beta-1a (Rebif). The patient takes this drug by subcutaneous injection three times a week. The dosage is 44 mcg per injection. If the patient takes an injection on Monday, how much of the drug would still be in the patient's system when she takes her next injection on Wednesday, assuming the half-life of the drug is 24 hours?
- A. 22 mcg
- B. 16.5 mcg
- C. 11 mcg
- D. 5.5 mcg
Correct Answer: C
Rationale: The half-life of a drug is the time it takes for the amount of drug in the body to decrease to 1 half the peak level it previously achieved. On Tuesday, there would be 22 mcg remaining in the body, so option A is incorrect. On Wednesday 11 mcg would remain, so option C is the correct answer. At 12 hours before taking the next dose on Wednesday, there would be 16.5 mcg remaining. If the injection were not taken on Wednesday, 12 hours after the dose was due, there would be 5.5 mcg remaining.
Where are large fenestrations or slit junctions located?
- A. Bone
- B. Brain
- C. Skin
- D. Liver
Correct Answer: D
Rationale: The liver has large fenestrations in sinusoidal endothelium, allowing easy drug passage, unlike the brain (tight junctions) or bone/skin (less permeable).
Patients with pernicious anemia require treatment with:
- A. Iron
- B. Folic acid
- C. Epogen alpha
- D. Vitamin B12
Correct Answer: D
Rationale: Pernicious anemia requires vitamin B12 due to absorption deficiency; folate masks it without correcting neuropathy.
A nurse is providing teaching to a client who has a new prescription for Digoxin. The nurse should instruct the client to monitor and report which of the following adverse effects that is a manifestation Digoxin toxicity? (Select one that does not apply.)
- A. Fatigue
- B. Constipation
- C. Anorexia
- D. Diplopia
Correct Answer: B
Rationale: Fatigue , anorexia , and diplopia are signs of digoxin toxicity.