Nokea
A client has been prescribed allopurinol (Zyloprim) for renal calculi that are caused by high uric acid levels. Which of the following indicate the client is experiencing adverse effect(s) of this drug? Select all that apply.
- A. Nausea.
- B. Rash.
- C. Constipation.
- D. Flushed skin.
- E. Bone marrow depression.
Correct Answer: A,B,E
Rationale: Nausea, rash, and bone marrow depression are known adverse effects of allopurinol, indicating potential toxicity or allergic reactions.
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A client is to be discharged from same-day surgery 7 hours after his inguinal hernia repair. Which of the following indicates this client is ready to be discharged?
- A. The client voids 500 mL of urine.
- B. The client tolerates eating a hamburger.
- C. The client is pain-free.
- D. The client walks in the hallway unassisted.
Correct Answer: A
Rationale: Voiding 500 mL indicates normal bladder function, a key discharge criterion after hernia repair, ensuring no urinary retention from anesthesia or surgery.
A client with ascites and peripheral edema is at risk for impaired skin integrity. To prevent skin breakdown, the nurse should:
- A. Institute range-of-motion (ROM) exercise every 4 hours.
- B. Massage the abdomen once a shift.
- C. Use an alternating air pressure mattress.
- D. Elevate the lower extremities.
Correct Answer: C
Rationale: An alternating air pressure mattress (C) prevents pressure ulcers in clients with edema and ascites. ROM exercises (A) and elevation (D) are supportive but secondary. Abdominal massage (B) is not indicated.
The nurse is teaching a client with a total knee replacement about incision care. Which statement by the client indicates a need for further teaching?
- A. I'll keep the incision clean and dry.'
- B. I'll report redness or drainage.'
- C. I'll change the dressing weekly.'
- D. I'll avoid soaking the incision.'
Correct Answer: C
Rationale: Changing the dressing weekly is too infrequent; daily or as-needed changes are required to monitor for infection.
When teaching a client to deep breathe effectively after a lobectomy, the nurse should instruct the client to do which of the following?
- A. Occurnt the abdominal muscles, take a slow deep breath through the nose and hold it for 3 to 5 seconds, then exhale.
- B. Contract the abdominal muscles, take a deep breath through the mouth, and exhale slowly as if trying to blow out a candle.
- C. Relax the abdominal muscles, take a slow deep breath through the nose, and hold it for 3 to 5 seconds.
- D. Relax the abdominal muscles, take a deep breath through the mouth, and exhale slowly over 10 seconds.
Correct Answer: C
Rationale: Effective deep breathing post-lobectomy involves relaxing abdominal muscles, taking a slow nasal breath, holding it 3–5 seconds, and exhaling to expand lungs. Contracting muscles or mouth breathing is less effective.
A client with deep vein thrombosis (DVT) has an edematous right lower extremity. The client lies on her right side frequently. Rubor is noted on the lateral aspect of the right ankle. From the data collected, the appropriate nursing diagnosis for this client would be:
- A. Activity intolerance related to complaints of pain in lower right extremity
- B. Ineffective health maintenance related to lack of knowledge about DVT
- C. Pain related to edema
- D. Risk for impaired skin integrity
Correct Answer: D
Rationale: Edema, frequent lying on the right side, and rubor (redness) indicate pressure and poor circulation, increasing the risk for skin breakdown. Risk for impaired skin integrity is the most appropriate nursing diagnosis. Activity intolerance, ineffective health maintenance, and pain are less specific to the data.