Nokea
A client is complaining of chest pain. Nursing assessment reveals a BP of 78/40, shortness of breath, and third-degree AV block on the heart monitor. What medication would the nurse prepare for initial administration?
- A. Atropine
- B. Verapamil (Calan)
- C. Lidocaine (Xylocaine)
- D. Procainamide (Pronestyl)
Correct Answer: A
Rationale: Third-degree AV block with hypotension (BP 78/40) requires atropine to increase heart rate by blocking vagal activity, improving cardiac output.
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The nurse is caring for a client with epilepsy who is being treated with carbamazepine (Tegretol). Which laboratory value might indicate a serious side effect of this drug?
- A. Uric acid of 5 mg/dL
- B. Hematocrit of 33%
- C. WBC 2000 per cubic millimeter
- D. Platelets 150,000 per cubic millimeter
Correct Answer: C
Rationale: A WBC of 2000 indicates leukopenia, a serious side effect of carbamazepine that increases infection risk.
The physician has ordered nitroglycerin buccal tablets for a client with stable angina. The nurse knows that nitroglycerin:
- A. Slows contractions of the heart
- B. Dilates coronary blood vessels
- C. Increases the ventricular fill time
- D. Strengthens contractions of the heart
Correct Answer: B
Rationale: Nitroglycerin dilates coronary blood vessels, improving blood flow to the myocardium and relieving angina.
Which of the following statements describes Piaget's stage of concrete operations?
- A. Reflex activity proceeds to imitative behavior.
- B. The ability to see another's point of view increases.
- C. Thought processes become more logical and coherent.
- D. The ability to think abstractly leads to logical conclusion.
Correct Answer: C
Rationale: Piaget's concrete operations stage (ages 7-11) is characterized by logical and coherent thought processes, enabling problem-solving with concrete objects.
The nurse is caring for a cognitively impaired client who begins to pull at the tape securing his IV site. To prevent the client from removing the IV, the nurse should:
- A. Place tape completely around the extremity, with tape ends out of the client's vision
- B. Tell him that if he pulls out the IV, it will have to be restarted
- C. Slap the client's hand when he reaches toward the IV site
- D. Apply clove hitch restraints to the client's hands
Correct Answer: A
Rationale: Securing the IV with tape out of the client's vision minimizes tampering while avoiding restraints or inappropriate actions.
The physician has ordered a blood test for H. pylori. The nurse should prepare the client by:
- A. Withholding oral intake after midnight
- B. Telling the client that no special preparation is needed
- C. Explaining that a small dose of radioactive isotope will be used
- D. Giving an oral suspension of glucose 1 hour before the test
Correct Answer: B
Rationale: A blood test for H. pylori requires no special preparation, such as fasting or administration of substances.