Nokea
A client is scheduled for a colonoscopy. Which of the following instructions should the nurse include in the pre-procedure teaching?
- A. Avoid solid foods for 24 hours before the procedure.
- B. Take all regular medications the morning of the procedure.
- C. Expect to be sedated during the procedure.
- D. Plan to stay overnight in the hospital.
Correct Answer: A, C
Rationale: Clear liquid diet for 24 hours prevents residue, and sedation is common during colonoscopy. Regular medications may need adjustment, and overnight stays are not typical.
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A client with a diagnosis of chronic obstructive pulmonary disease (COPD) is prescribed ipratropium (Atrovent). The nurse should teach the client that this medication works by:
- A. Reducing inflammation in the airways.
- B. Dilating the bronchioles.
- C. Thinning mucus secretions.
- D. Suppressing the cough reflex.
Correct Answer: B
Rationale: Ipratropium, an anticholinergic, dilates bronchioles, improving airflow in COPD.
Which site or technique would you expect to use to administer ferrous sulfate?
- A. A subcutaneous injection site
- B. The PQRST technique
- C. The Z track technique
- D. The sublingual site
Correct Answer: C
Rationale: The Z-track technique is used for ferrous sulfate IM injections to prevent leakage and skin staining.
The nurse is assessing a neonate at 5 minutes after birth. The nurse records the Apgar score based on the findings in the chart A. The nurse compares these findings to the Apgar score obtained at birth, as determined by the findings in the chart B. What should the nurse do next?
- A. Notify the neonatologist on call.
- B. Continue to assess the neonate.
- C. Apply an oxygen mask.
- D. Rub the neonate’s extremities.
Correct Answer: B
Rationale: The neonate’s Apgar score has been improving since birth. (The birth score is 6; the current score is 9.) The nurse should continue to assess the neonate. There is no indication that oxygen is
needed since the color is improving, and stimulating the baby is not necessary as the he is now fl exing his extremities.
For which of the following should the nurse be especially alert when caring for a term neonate, who weighed 10 lb at birth, 1 hour after a vaginal delivery?
- A. Hypoglycemia.
- B. Hypercalcemia.
- C. Hypermagnesemia.
- D. Hyperbilirubinemia.
Correct Answer: A
Rationale: The neonate would be considered large for gestational age (LGA) because the neonate weighs more than 4,000 g (90th percentile). Hypoglycemia is a problem for the LGA neonate because glycogen stores are quickly used to maintain the weight. Other complications like hyperbilirubinemia may occur, but hypoglycemia is the priority concern within the first hour.
A male client has been diagnosed as having a low sperm count during infertility studies. After instructions by the nurse about some causes of low sperm counts, the nurse determines that the client needs further instructions when he says low sperm counts may be caused by which of the following?
- A. Varicocele.
- B. Frequent use of saunas.
- C. Endocrine imbalances.
- D. Decreased body temperature.
Correct Answer: D
Rationale: Decreased body temperature is not a cause of low sperm count; elevated temperatures, such as from saunas, can impair spermatogenesis, indicating a need for further teaching.