Nokea
A 70-year-old man with a history of hypertension and closed-angle glaucoma visits the clinic for a routine check-up. Which of the following medications, if ordered by the physician, should the nurse question?
- A. Propranolol (Inderal), 80 mg PO QID.
- B. Verapamil (Nifedipine), 40 mg PO TID.
- C. Tetrahydrozoline (Visine), 2 gtts OU TID.
- D. Timolol (Timoptic solution), 1 gtt OU QD.
Correct Answer: C
Rationale: contraindicated; ophthalmic vasoconstrictor, contraindicated with closed angle glaucoma; use cautiously with hypertension
You may also like to solve these questions
The nurse is caring for a client who is receiving IV ceftriaxone for a urinary tract infection. Which of the following findings would be of GREATest concern to the nurse?
- A. White blood cell count of 12,000/mm^3.
- B. Temperature of 100.4°F (38°C).
- C. Urine output of 50 mL/hour.
- D. Blood pressure of 120/80 mmHg.
Correct Answer: B
Rationale: A temperature of 100.4°F suggests worsening infection or inadequate antibiotic coverage, requiring immediate evaluation. Options A, C, and D are less concerning: WBC 12,000/mm^3 is expected, urine output 50 mL/hour is normal, and blood pressure 120/80 mmHg is stable.
The nurse is caring for a woman who is receiving internal radiation for cancer of the cervix. Which nursing action will do most to reduce the risk of radiation exposure to other clients?
- A. Keep the door to the client's room closed.
- B. Place the client in the bed closest to the outside window.
- C. Place the client in a room close to the nurse's station for continuous observation.
- D. Place a 'Do not enter' sign on the door to the client's room.
Correct Answer: A
Rationale: Keeping the door closed minimizes radiation exposure to others by containing emissions. Bed placement or signs are less effective, and observation doesn't reduce exposure.
The nurse is caring for a client who is post-op following a thoracotomy. The client has 2 chest tubes in place, connected to 1 chest drain. The nursing assessment reveals bubbling in the water seal chamber when the client coughs. What is the most appropriate nursing action?
- A. Clamp the chest tube
- B. Call the surgeon immediately
- C. Continue to monitor the client to see if the bubbling increases
- D. Instruct the client to try to avoid coughing
Correct Answer: C
Rationale: Bubbling associated with coughing after lung surgery is to be expected as small amounts of air escape the pleural space when pressures inside the chest increase with coughing. Monitoring is the only nursing action required at this time.
Which item should be kept at the bedside of a client who has just returned from having a thyroidectomy?
- A. A padded tongue
- B. An endotracheal tube
- C. An airway
- D. A tracheostomy set
Correct Answer: D
Rationale: A tracheostomy set is essential due to the risk of airway obstruction from swelling or hemorrhage post-thyroidectomy. Options A, B, and C are less critical in this context.
The nurse is caring for a client in the coronary care unit. The display on the cardiac monitor indicates ventricular fibrillation. What should the nurse do first?
- A. Perform defibrillation
- B. Administer epinephrine as ordered
- C. Assess for presence of pulse
- D. Institute CPR
Correct Answer: C
Rationale: Assess for presence of pulse. Verifying the absence of a pulse confirms ventricular fibrillation before proceeding with treatment.