Nokea
A 72 year-old client is scheduled to have a cardioversion. A nurse reviews the client's medication administration record. The nurse should notify the health care provider if the client received which medication during the preceding 24 hours?
- A. Digoxin (Lanoxin)
- B. Diltiazem (Cardizem)
- C. Nitroglycerine ointment
- D. Metoprolol (Toprol XL)
Correct Answer: A
Rationale: Digoxin (Lanoxin). Digoxin increases ventricular irritability and increases the risk of ventricular fibrillation following cardioversion. The other medications do not increase ventricular irritability.
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A registered nurse (RN) asks the licensed practical nurse (LPN) to hang blood on a client. What is the best response by the LPN?
- A. Carefully check the order and the client identification and hang the unit if all is in order.
- B. Ask the RN to verify the order and then administer as ordered.
- C. Hang the blood after taking baseline vital signs.
- D. Refuse to administer the blood.
Correct Answer: D
Rationale: LPN scope of practice typically excludes initiating blood transfusions due to the need for specialized monitoring, requiring RN administration.
A post-operative client is admitted to the post-anesthesia recovery room (PACU). The anesthetist reports that malignant hyperthermia occurred during surgery. The nurse recognizes that this complication is related to what factor?
- A. Allergy to general anesthesia
- B. Pre-existing bacterial infection
- C. A genetic predisposition
- D. Selected surgical procedures
Correct Answer: C
Rationale: Malignant hyperthermia is a rare, potentially fatal adverse reaction to inhaled anesthetics. There is a genetic predisposition to this disorder.
Included in teaching the client with tuberculosis taking isoniazid (INH) about follow-up home care, the nurse should emphasize that a laboratory appointment for which of the following lab tests is critical?
- A. Liver function
- B. Kidney function
- C. Blood sugar
- D. Cardiac enzymes
Correct Answer: A
Rationale: Liver function. INH can cause hepatocellular injury and hepatitis. This side effect is age-related and can be detected with regular assessment of liver enzymes, which are released into the blood from damaged liver cells.
The nurse is caring for a client with cirrhosis of the liver with ascites. When instructing nursing assistants in the care of the client, the nurse should emphasize that the client
- A. Should remain on bed rest in a semi-Fowler's position
- B. Should alternate ambulation with bed rest with legs elevated
- C. May ambulate and sit in chair as tolerated
- D. May ambulate as tolerated and remain in semi-Fowlers position in bed
Correct Answer: B
Rationale: Should alternate ambulation with bed rest with legs elevated. Encourage alternating periods of ambulation and bed rest with legs elevated to mobilize edema and ascites.
The nurse is caring for a client with a history of chronic obstructive pulmonary disease (COPD) who is receiving oxygen at 2 L/min via nasal cannula. Which of the following findings would be of GREATest concern to the nurse?
- A. Oxygen saturation of 90%.
- B. Respiratory rate of 20 breaths/min.
- C. Temperature of 101°F (38.3°C).
- D. Heart rate of 80 bpm.
Correct Answer: C
Rationale: A temperature of 101°F suggests infection, a serious complication in COPD that can exacerbate respiratory distress. Options A, B, and D are acceptable: oxygen saturation 90% is adequate for COPD, respiratory rate 20 is normal, and heart rate 80 bpm is normal.