Nokea
A 75-year-old client who has been taking furosemide (Lasix) regularly for 4 months tells the nurse that he is having trouble hearing. What would be the nurse's best response to this statement?
- A. Tell the client that because he is 75 years old, it is inevitable that his hearing should begin to deteriorate.
- B. Have the client immediately report the hearing loss to his physician.
- C. Schedule the client for audiometric testing and a hearing aid.
- D. Tell the client that the hearing loss is only temporary; when his system adjusts to the furosemide, his hearing will improve.
Correct Answer: B
Rationale: Furosemide can cause ototoxicity, leading to hearing loss. The nurse should advise the client to report this to the physician promptly for further evaluation and management.
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A male client with a head injury regains consciousness and the normal loss. Which of the following nursing statements is most appropriate as the client awakens?
- A. I'll get your family.
- B. Can you tell me your name and where you live?
- C. I'll bet you're a little confused right now.
- D. You are in the hospital. You were in an accident and unconscious.
Correct Answer: D
Rationale: Providing clear, concise orientation information is most appropriate for a client regaining consciousness to reduce confusion and anxiety. Calling family, asking for personal details, or assuming confusion may overwhelm or distress the client.
The nurse is planning a staff development conference about medication safety. Which of the following medications should have a second medication check prior to administration? Select all that apply.
- A. heparin infusion
- B. regular insulin
- C. 0.9% sodium chloride (normal saline) flush
- D. patient-controlled analgesia (PCA)
- E. oxytocin infusion
- F. total parenteral nutrition
Correct Answer: A,B,D,E,F
Rationale: High-risk medications like heparin, insulin, PCA, oxytocin, and TPN require a second check to prevent errors.
A client with suspected gastric cancer undergoes an endoscopy of the stomach. Which of the following assessments made after the procedure would indicate the development of a potential complication?
- A. The client complains of a sore throat.
- B. The client displays signs of sedation.
- C. The client experiences a sudden increase in temperature.
- D. The client demonstrates a lack of appetite.
Correct Answer: C
Rationale: A sudden increase in temperature post-endoscopy may indicate a complication such as perforation or infection, requiring immediate assessment. Sore throat, sedation, and lack of appetite are expected or unrelated findings.
A client with Buerger's disease has established a goal to stop smoking. Which medication would be the most helpful in attaining this goal?
- A. Zyban (Bupropion)
- B. Nicotine (Nicotrol)
- C. Nitroglycerin (Tridil)
- D. Ibuprofen (Advil)
Correct Answer: A
Rationale: Zyban (bupropion) is an antidepressant that reduces nicotine cravings and withdrawal symptoms, making it effective for smoking cessation in Buerger's disease. Nicotine replacement (Nicotrol) may help but continues nicotine exposure, nitroglycerin is for angina, and ibuprofen is irrelevant.
The nurse should caution the client with diabetes mellitus who is taking a sulfonylurea that alcoholic beverages should be avoided while taking these drugs because they can cause which of the following?
- A. Hypokalemia.
- B. Hyperkalemia.
- C. Hypocalcemia.
- D. Disulfiram (Antabuse)-like symptoms.
Correct Answer: D
Rationale: Sulfonylureas combined with alcohol can cause disulfiram-like symptoms, such as flushing, nausea, and palpitations.