Nokea
A client diagnosed with cirrhosis is started on lactulose (Cephulac). The main purpose of the drug for this client is to
- A. add dietary fiber
- B. reduce ammonia levels
- C. stimulate peristalsis
- D. control portal hypertension
Correct Answer: B
Rationale: Lactulose blocks the absorption of ammonia from the GI tract and secondarily stimulates bowel elimination.
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While sitting in the cafeteria, a nurse overhears two students discussing a client admitted for chemical detoxification. The nurse should:
- A. Report the incident to the teacher.
- B. Report the incident to the nursing supervisor.
- C. Confront the students with their behavior.
- D. Ignore the students' behavior.
Correct Answer: C
Rationale: Confronting the students addresses the breach of confidentiality directly and educates them. Reporting to the teacher or supervisor escalates unnecessarily, and ignoring the behavior allows the violation to persist.
A client who has congestive heart failure is being admitted. How should the nurse position this client?
- A. Supine
- B. Sims'
- C. Semi-sitting
- D. Side-lying
Correct Answer: C
Rationale: Semi-sitting (Fowler's position) reduces cardiac workload and improves breathing in congestive heart failure by decreasing venous return.
The nurse is talking with a client who has a new prescription for metronidazole. Which of the following statements by the client would require follow up?
- A. I can continue to drink a glass of wine with dinner while I am taking this medication'
- B. I might experience a metallic taste in my mouth while I am taking this medication'
- C. I should not be concerned if my urine turns a dark color while taking this medication'
- D. I will immediately contact my health care provider if I experience a rash or skin peeling.'
Correct Answer: A
Rationale: Drinking alcohol while taking metronidazole can cause a disulfiram-like reaction, requiring follow-up. Metallic taste and dark urine are common side effects, and reporting rash or peeling is appropriate.
An elderly man has just returned from the operating room where he spent several hours in lithotomy position during a perineal prostatectomy. Which assessment should the nurse make because the client was in lithotomy position during surgery?
- A. Lower extremity pulses, paresthesias, and pain
- B. The presence of bowel sounds
- C. Radial pulse, sensation, and movement of the arms
- D. Palpation of the bladder
Correct Answer: A
Rationale: Prolonged lithotomy position risks nerve compression and impaired circulation in the lower extremities, necessitating assessment of pulses, paresthesias, and pain to detect complications like compartment syndrome.
The nurse is caring for a client who had surgery yesterday. When administering omeprazole, the client asks 'What is that for? I don't take it at home.' Which reply by the nurse is most appropriate?
- A. Omeprazole helps prevent nausea by making your stomach empty faster.'
- B. Omeprazole helps prevent you from developing an ulcer due to the stress of surgery.'
- C. Omeprazole protects you from getting an infection while on antibiotics.'
- D. This medication will treat your gastroesophageal reflux disease (GERD).'
Correct Answer: B
Rationale: Omeprazole is a proton pump inhibitor used postoperatively to prevent stress ulcers due to surgical stress. It does not affect gastric emptying , prevent infections , or assume GERD without a diagnosis.