Nokea
A client is medically cleared for ECT and is tentatively scheduled for six treatments over a 2-week period. Her husband asks, 'Isn't that a lot?' The nurse's best response is:
- A. Yes, that does seem like a lot.'
- B. You'll have to talk to the doctor about that. The physician knows what's best for the client.'
- C. Six to 10 treatments are common. Are you concerned about permanent effects?'
- D. Don't worry. Some clients have lots more than that.'
Correct Answer: C
Rationale: The most common range for affective disorders is 6-10 treatments. This response confirms and reinforces the physician's plan for treatment. It also opens communication with the husband to identify underlying fears and knowledge deficits.
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Which of the following instructions should be included in the nurse's teaching regarding oral contraceptives?
- A. Weight gain should be reported to the physician.
- B. An alternate method of birth control is needed when taking antibiotics.
- C. If the client misses one or more pills,two pills should be taken per day for one week.
- D. Changes in the menstrual flow should be reported to the physician.
Correct Answer: B
Rationale: Antibiotics can reduce the effectiveness of oral contraceptives by altering gut flora necessitating an alternate birth control method during antibiotic use. Weight gain and menstrual changes are common and doubling pills is not the correct protocol for missed doses.
The mother of a child with chickenpox wants to know if there is a medication that will shorten the course of the illness. Which medication is sometimes used to speed healing of the lesions and shorten the duration of fever and itching?
- A. Zovirax (acyclovir)
- B. Varivax (varicella vaccine)
- C. VZIG (varicella-zoster immune globulin)
- D. Periactin (cyproheptadine)
Correct Answer: A
Rationale: Acyclovir (Zovirax) is an antiviral that can reduce the severity and duration of chickenpox symptoms, including lesions, fever, and itching.
The physician has ordered 50 mEq of potassium chloride for a client with a potassium level of 2.5 mEq/L. The nurse should administer the medication:
- A. Slow, continuous IV push over 10 minutes
- B. Continuous infusion over 30 minutes
- C. Controlled infusion over five hours
- D. Continuous infusion over 24 hours
Correct Answer: C
Rationale: Potassium chloride for hypokalemia (2.5 mEq/L) should be administered via controlled IV infusion over several hours (e.g., five hours) to prevent rapid shifts that could cause arrhythmias.
The client is admitted with left-sided congestive heart failure. In assessing the client for edema, the nurse should check the:
- A. Feet
- B. Neck
- C. Hands
- D. Sacrum
Correct Answer: D
Rationale: In left-sided congestive heart failure, fluid backs up into the lungs, but dependent edema is assessed in the sacrum in bedridden clients or feet in ambulatory clients. The sacrum is the most appropriate site for hospitalized clients, as they are often recumbent.
The nurse is caring for a client with acromegaly. Following a transphenoidal hypophysectomy, the nurse should:
- A. Monitor the client's blood sugar.
- B. Suction the mouth and pharynx every hour.
- C. Place the client in low Trendelenburg position.
- D. Encourage the client to cough.
Correct Answer: A
Rationale: Transphenoidal hypophysectomy can disrupt pituitary function, affecting glucose regulation. Monitoring blood sugar is critical to detect hypo- or hyperglycemia. Suctioning, positioning, or coughing is not routine.