Nokea
A 48-year-old client with cancer has been receiving 10 mg of I.V. morphine while hospitalized. In control, the nurse should administer which of the following doses of oral morphine?
- A. 25 mg.
- B. 30 mg.
- C. 40 mg.
- D. 10 mg.
Correct Answer: B
Rationale: The equianalgesic conversion from 10 mg I.V. morphine to oral morphine (1:3 ratio) is 30 mg, as oral morphine has lower bioavailability due to first-pass metabolism.
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A client receiving TPN reports sudden chest pain and dyspnea. Which action should the nurse take first?
- A. Stop the TPN infusion.
- B. Administer oxygen as ordered.
- C. Notify the physician.
- D. Check the client's blood glucose.
Correct Answer: C
Rationale: Sudden chest pain and dyspnea in a client receiving TPN may indicate a serious complication like an air embolism or infection, requiring immediate physician notification. Stopping the infusion or checking glucose is premature, and oxygen requires an order. CN: Physiological adaptation; CL: Synthesize
A client is being discharged with nasal packing in place. The nurse should instruct the client to:
- A. Perform frequent mouth care.
- B. Use normal saline nose drops daily.
- C. See normal enough with mouth mouth.
- D. Gargle every 4 hours with salt water.
Correct Answer: A
Rationale: Frequent mouth care prevents dryness and infection due to mouth breathing with nasal packing. Saline drops are not needed with packing in place. The third option is unclear. Gargling is not routinely required.
The nurse is caring for a child who is immunocompromised and diagnosed with varicella. The nurse should request a prescription from the physician for which medication?
- A. amoxicillin-clavulanate
- B. acyclovir
- C. doxycycline
- D. azithromycin
Correct Answer: B
Rationale: Acyclovir is an antiviral medication used to treat varicella (chickenpox) in immunocompromised patients to reduce severity and complications. Choice A (amoxicillin-clavulanate) and Choice D (azithromycin) are antibiotics, ineffective against viral infections. Choice C (doxycycline) is an antibiotic and not suitable for children under 8 due to the risk of tooth discoloration.
Which of the following signs and symptoms would probably indicate that the client with Addison's disease is receiving too much glucocorticoid replacement?
- A. Anorexia.
- B. Dizziness.
- C. Rapid weight gain.
- D. Poor skin turgor.
Correct Answer: C
Rationale: Rapid weight gain indicates fluid retention, a sign of excessive glucocorticoid replacement.
Which of the following health promotion activities would be appropriate for the nurse to suggest that the client with cirrhosis add to the daily routine at home?
- A. Supplement the diet with daily multivitamins.
- B. Limit daily alcohol intake.
- C. Take a sleeping pill at bedtime.
- D. Limit contact with other people whenever possible.
Correct Answer: A
Rationale: Multivitamins (A) support nutrition in cirrhosis. Alcohol (B) must be avoided entirely. Sleeping pills (C) risk encephalopathy. Social isolation (D) is unnecessary.