Nokea
A client in the hospital is receiving chemotherapy. Based on today’s blood laboratory results, which of the following actions should the nurse take?
- A. Check for hematuria
- B. Check for peaked T waves
- C. Obtain prescription for epoetin alfa
- D. Place a face mask on the client
Correct Answer: D
Rationale: Chemotherapy often causes neutropenia, increasing infection risk. A face mask (D) protects the client. Hematuria (A), peaked T waves (B), and epoetin (C) address other issues not directly indicated.
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A client is diagnosed as having secondary Cushing's syndrome. The nurse knows that the client has most likely been taking which medication?
- A. Estrogen
- B. Penicillin
- C. Lovastatin
- D. Prednisone
Correct Answer: D
Rationale: Secondary Cushing's syndrome is often caused by long-term prednisone use, a corticosteroid mimicking cortisol excess. Estrogen, penicillin, or lovastatin do not cause this condition.
The doctor has ordered Nitrostat (nitroglycerine) sublingually for a client with angina. The client should be ordered to replenish his supply every:
- A. 6 months
- B. 3 months
- C. 12 months
- D. 18 months
Correct Answer: A
Rationale: Nitroglycerin loses potency after 6 months, requiring replacement to ensure efficacy for angina relief.
The nurse is preparing to administer the fourth dose of vancomycin IVPB to a client with infective endocarditis. Which intervention should the nurse anticipate?
- A. Starting a new IV line before the administration
- B. Administering an antiemetic PRN prior to the infusion
- C. Administering medication via an infusion pump over at least 30 minutes
- D. Obtaining a serum trough level 15-30 minutes before the administration of vancomycin
Correct Answer: D
Rationale: Vancomycin requires therapeutic drug monitoring to ensure efficacy and prevent toxicity. Obtaining a serum trough level 15-30 minutes before the fourth dose (D) is standard to guide dosing adjustments. A new IV line (A) is unnecessary unless the current line is compromised. Antiemetics (B) are not routinely needed. Infusion over 60 minutes (C) is typical to prevent red man syndrome, not 30 minutes.
The nurse is making a home visit to an adult who had a cataract extraction yesterday. Which observation indicates that the client needs more instruction?
- A. The client demonstrates putting eye drops in the conjunctival sac.
- B. The client has a patch on the affected eye.
- C. The client bends over to pick up the cat.
- D. The client is wearing slip-on shoes.
Correct Answer: C
Rationale: Bending over post-cataract surgery increases intraocular pressure, risking complications; this indicates a need for further instruction on activity restrictions.
A client diagnosed with trichomonal vaginal infection (trichomoniasis) is prescribed metronidazole. Which directions are essential for the nurse to reinforce? Select all that apply.
- A. Avoid alcohol while taking this medication
- B. Perform vaginal douche for 7-10 days
- C. Use birth control pills to prevent infection recurrence
- D. Your partner(s) must be treated simultaneously
- E. Your urine can change to a deep red-brown color
Correct Answer: A,D,E
Rationale: Metronidazole treatment for trichomoniasis requires specific instructions. Avoiding alcohol (A) prevents a disulfiram-like reaction. Partner treatment (D) is essential to prevent reinfection, as trichomoniasis is sexually transmitted. Urine discoloration (E) is a possible side effect to anticipate. Douching (B) is not recommended, as it disrupts vaginal flora. Birth control pills (C) do not prevent recurrence of this infection.