Nokea
A client is scheduled to have surgery. The nurse should place priority on determining whether the surgeon wants which medications held in the preoperative period to assure client safety?
- A. Warfarin
- B. Furosemide
- C. Famotidine
- D. Multivitamin with minerals
Correct Answer: A
Rationale: The nurse is careful to question the surgeon about whether warfarin should be administered in the preoperative period. This medication is often withheld for a period of time preoperatively to minimize the risk of hemorrhage during surgery. The other medications may also be withheld if specifically prescribed, but usually they are discontinued as part of an NPO (nothing by mouth) after midnight prescription.
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Your pediatric client weighs 48 pounds. How many mg of a medication would you administer to this client with each dose when the doctor has ordered 5 mg/kg/day in two equally divided doses?
- A. 45 mg
- B. 60 mg
- C. 52 mg
- D. 55 mg
Correct Answer: C
Rationale: To calculate: 48 pounds ÷ 2.2 = 21.82 kg. Then, 5 mg/kg × 21.82 kg = 109.1 mg/day. Divided into two doses: 109.1 ÷ 2 = 54.55 mg, rounded to 52 mg per dose.
A client with chronic renal failure is receiving epoetin alfa (Epogen). The nurse should monitor the client for which of the following adverse effects?
- A. Hypertension.
- B. Hypoglycemia.
- C. Bradycardia.
- D. Hypokalemia.
Correct Answer: A
Rationale: Epoetin alfa can cause hypertension due to increased red blood cell production and blood viscosity, requiring close monitoring.
Which of these case management methods employs the intrinsic use of multidisciplinary plans of care that are based on the client's current condition, and reflect interventions and expected outcomes within a pre-established time line?
- A. The Case Manager Model
- B. The ProACT Model
- C. The Collaborative Practice Model
- D. The Triad Model of Case Management
Correct Answer: D
Rationale: The Triad Model of Case Management uses multidisciplinary plans of care based on the client's current condition, with interventions and expected outcomes within a pre-established timeline, involving collaboration among nursing, social work, and utilization review teams.
A client with a history of chronic kidney disease is prescribed furosemide (Lasix). The nurse should monitor the client for which of the following electrolyte imbalances? Select all that apply.
- A. Hypokalemia.
- B. Hyponatremia.
- C. Hypomagnesemia.
- D. Hypercalcemia.
- E. Hypophosphatemia.
Correct Answer: A, B, C
Rationale: Furosemide can cause hypokalemia, hyponatremia, and hypomagnesemia due to electrolyte loss.
A client has been diagnosed with viral hepatitis. Which of the following goals is most appropriate for the client?
- A. Achieve control of abdominal pains
- B. Increase activity levels gradually
- C. Reduce jaundice
- D. Prevent liver damage
Correct Answer: B
Rationale: Increasing activity levels gradually is an appropriate goal for viral hepatitis, as rest is needed initially but gradual return to activity supports recovery. Pain is less common, and jaundice or liver damage prevention are secondary.