Nokea
A client is scheduled for a myelogram. Which of the following medications orders should be questioned?
- A. Ampicillin (Pencipen) $250 \mathrm{mg} \mathrm{PO} \mathrm{q} 6$ hours
- B. Motrin (Ibuprofen) $400 \mathrm{mg} \mathrm{PO} \mathrm{q} 4$ hours PRN for headache
- C. Secobarbital (Seconal) $50 \mathrm{mg}$ HS PRN for sleep
- D. Propoxyphene (Darvon) $65 \mathrm{mg} \mathrm{PO} \mathrm{q} 4$ hours for pain
Correct Answer: B
Rationale: Ibuprofen (Motrin) has anticoagulant properties, increasing bleeding risk during a myelogram, a procedure involving spinal puncture. Other medications are safer.
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The nurse is caring for a client who had surgery yesterday. When administering omeprazole, the client asks 'What is that for? I don't take it at home.' Which reply by the nurse is most appropriate?
- A. Omeprazole helps prevent nausea by making your stomach empty faster.'
- B. Omeprazole helps prevent you from developing an ulcer due to the stress of surgery.'
- C. Omeprazole protects you from getting an infection while on antibiotics.'
- D. This medication will treat your gastroesophageal reflux disease (GERD).'
Correct Answer: B
Rationale: Omeprazole is a proton pump inhibitor used postoperatively to prevent stress ulcers due to surgical stress. It does not affect gastric emptying , prevent infections , or assume GERD without a diagnosis.
The nurse is preparing to give a heparin injection to a client who is severely malnourished and has minimal adipose tissue. Which method of injection would be appropriate for this client?
- A. EX12_Q49_1.PNG
- B. EX12_Q49_2.PNG
- C. EX12_Q49_3.PNG
- D. EX12_Q49_4.PNG
Correct Answer: C
Rationale: For a malnourished client with minimal adipose tissue, heparin should be injected at a 90-degree angle using a 25-gauge needle to ensure subcutaneous delivery without hitting muscle.
The nurse in the emergency department is caring for a newborn who has been vomiting. Which of the following findings may indicate that the newborn is experiencing a bowel obstruction?
- A. green colored vomit
- B. occasional vomiting since birth
- C. tiny streaks of blood in the vomit
- D. vomit coming through the nose
Correct Answer: A
Rationale: Green-colored vomit in a newborn suggests bile, indicating a possible bowel obstruction like malrotation or volvulus. Occasional vomiting , blood streaks , and nasal vomit are less specific.
The nurse understands that a priority goal of involuntary hospitalization of the severely mentally ill client is
- A. Re-orientation to reality
- B. Elimination of symptoms
- C. Protection from harm to self or others
- D. Return to independent functioning
Correct Answer: C
Rationale: Protection from harm to self or others. Involuntary hospitalization is required for individuals who are dangerous to themselves or others.
The nurse in the outpatient clinic is caring for a client with heart failure who reports increased ankle swelling and a 3-lb (1.4-kg) weight gain over the past 2 days. The nurse reviews the client's current medications and anticipates the need for an increase in the dosage of which of the following medications?
- A. Bumetanide
- B. Candesartan
- C. Carvedilol
- D. Isosorbide
Correct Answer: A
Rationale: A 3-lb weight gain and ankle swelling in heart failure indicate fluid retention, requiring an increased dose of a diuretic like bumetanide . Candesartan , carvedilol , and isosorbide manage other aspects but do not directly address acute fluid overload.