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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The nurse observes a nursing assistant caring for an 86-year-old woman who had an open reduction/internal fixation for a fractured femur two days ago. Which action by the nursing assistant needs correction by the nurse?
- A. The nursing assistant places an abductor pillow between the client's legs while turning the client.
- B. The nursing assistant asks the client to put full weight on both legs while using the walker.
- C. The nursing assistant has a high extended bedside commode available for the client.
- D. The nursing assistant encourages the client to bathe herself.
Correct Answer: B
Rationale: Full weight-bearing two days post-femur fixation is inappropriate, risking hardware failure; partial or non-weight-bearing is typical. Abductor pillows, commodes, and self-bathing are appropriate.
The nurse is caring for a client with oral candidiasis who has a new prescription for nystatin oral suspension. Which of the following actions should the nurse take? Select all that apply.
- A. Tell the client to avoid eating or drinking for at least 30 minutes after taking nystatin.
- B. Monitor the client's oral mucous membranes for redness, swelling, and irritation.
- C. Remind the client to discontinue the nystatin once the symptoms subside.
- D. Shake the bottle of nystatin thoroughly before measuring the dose.
- E. Instruct the client to swish the nystatin around the mouth.
Correct Answer: A,B,D,E
Rationale: For nystatin oral suspension: avoid eating/drinking for 30 minutes to ensure contact time; monitor oral membranes for treatment response; shake the bottle for proper dosing; and swish in the mouth for efficacy. Discontinuing early risks recurrence.
The nurse prepares equipment for insertion of a large bore nasogastric (NG) tube for a hospitalized client. Which actions should the nurse take to measure and mark the tube? Select all that apply.
- A. Fold tube in half and mark at the halfway point
- B. Extend tape measure from naris to stomach
- C. Measure from tip of nose to earlobe to xiphoid process
- D. Place a small piece of tape at the point of measurement
- E. Use rubber clamp after measuring to mark the point of measurement
Correct Answer: C,D
Rationale: To measure an NG tube, measure from nose to earlobe to xiphoid process for approximate insertion depth and mark with tape . Folding in half is inaccurate, measuring to stomach is vague, and rubber clamps are not standard.
The most common complication following a myocardial infarction is:
- A. Hyperkalemia
- B. Cardiac dysrhythmia
- C. Acute respiratory distress
- D. Hypovolemic shock
Correct Answer: B
Rationale: Cardiac dysrhythmias are the most common complication post-myocardial infarction due to ischemic changes affecting the heart's electrical conduction.
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.