Nokea
A client has just been prescribed allopurinol for chronic gout. Which instruction is most important for the nurse to reinforce to the client?
- A. Report for periodic laboratory tests for kidney, liver, and blood functions
- B. Store the medication in a cool, dry place away from direct heat and light
- C. Take the medication after a meal to prevent gastric distress
- D. Take the medication with a full glass of water and increase fluids during the day
Correct Answer: A
Rationale: Allopurinol can affect kidney, liver, and bone marrow function, so periodic lab tests are critical to monitor for toxicity. Storage instructions, taking with food, and fluid intake are important but less critical than ensuring organ function safety.
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Central venous access devices (CVADs) are frequently utilized to administer chemotherapy. What is an advantage of using CVADs for chemotherapeutic agent administration?
- A. CVADs are less expensive than a peripheral IV.
- B. Weekly administration is possible.
- C. Chemotherapeutic agents can be caustic to smaller veins.
- D. The client or family can administer the drug at home.
Correct Answer: C
Rationale: Many chemotherapeutic agents are vesicants, damaging smaller peripheral veins. CVADs allow safe administration into larger veins. CVADs are more expensive, dosing varies, and home administration is rare. Pharmacological Therapies
The nurse in the outpatient mental health clinic is evaluating the effectiveness of the treatment regimen for a client with dependent personality disorder. Which of the following statements by the client would indicate that the treatment regimen has been effective?
- A. I took the bus here today because my parents could not drive me.
- B. I appreciate all the time you have spent trying to help me feel better.
- C. I know I am not good at my job because I made a mistake at work today.
- D. I plan to stay with my cousin while my parents go away on vacation next week.
Correct Answer: A
Rationale: Clients with dependent personality disorder have a persistent and extreme need to be taken care of that manifests as submissive and clinging behaviors and fear of separation. Additional characteristics of dependent personality disorder may include:• Difficulty in making day-to-day decisions • An excessive need for advice, reassurance, and nurturing from others • Lack of self-confidence or fear of doing things independently • Fear of confrontation or expressing disagreement with others • Feelings of helplessness and anxiety when alone or fear of being unable to take care of oneself The ability to make decisions about and carry out daily activities without assistance (eg, planning alternate transportation) indicate that the treatment plan has been effective
The nurse is caring for a client with bacterial meningitis who has been placed on droplet precautions. Which personal protection is mandatory for the nurse when administering medications?
- A. Face shield
- B. Gown
- C. N95 respirator
- D. Surgical mask
Correct Answer: D
Rationale: Droplet precautions for bacterial meningitis require a surgical mask to prevent transmission via respiratory droplets. A face shield, gown, or N95 respirator is not mandatory unless additional precautions are indicated.
The client's lab culture report is negative for a suspected infection. A test that can correctly identify those who do not have a given disease is:
- A. specific.
- B. sensitive.
- C. negative culture.
- D. marginal finding.
Correct Answer: A
Rationale: A specific test accurately identifies those without the disease (true negatives). Sensitivity identifies those with the disease. The other terms are unrelated to test performance. Safety and Infection Control
A nurse enters a client's room to discover that the client has no pulse or respirations. After calling for help, the first action the nurse should take is
- A. start a peripheral IV
- B. initiate closed-chest massage
- C. establish an airway
- D. obtain the crash cart
Correct Answer: C
Rationale: Establishing an open airway is always the primary objective in a cardiopulmonary arrest.