Nokea
A client is to receive epoetin (Epogen) injections. What laboratory value should the nurse assess before giving the injection?
- A. Hematocrit.
- B. Partial thromboplastin time.
- C. Hemoglobin concentration.
- D. Prothrombin time.
Correct Answer: A
Rationale: Epoetin (Epogen) stimulates red blood cell production and is used to treat anemia. The nurse should assess hematocrit before administration to evaluate the client's response to therapy and ensure levels do not rise excessively, which can increase the risk of hypertension or thrombosis. Hemoglobin is also relevant but hematocrit is more commonly monitored. Coagulation times are not directly affected by epoetin.
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The nurse is caring for a client who is receiving the prescribed hydromorphone. Which of the following side effects should the nurse look for in the client? Select all that apply.
- A. Urinary incontinence
- B. Pupil dilation
- C. Diarrhea
- D. Altered level of consciousness (LOC)
- E. Constipation
Correct Answer: D,E
Rationale: Hydromorphone, an opioid, can cause altered level of consciousness and constipation. Urinary incontinence, pupil dilation, and diarrhea are not typical side effects.
The nurse should instruct the client with a platelet count of less than 150,000/µL to avoid which of the following activities?
- A. Ambulation.
- B. Valsalva's maneuver.
- C. Visiting with children.
- D. Semi-Fowler's position.
Correct Answer: B
Rationale: A platelet count below 150,000/µL indicates thrombocytopenia, increasing bleeding risk. Valsalva's maneuver (e.g., straining during bowel movements) can raise intracranial pressure and cause bleeding, such as cerebral hemorrhage, and should be avoided. Ambulation, visiting children, and semi-Fowler's position are generally safe unless other conditions are present.
The nurse is caring for a client who is receiving prescribed ketorolac. Which of the following client findings would indicate a therapeutic response? Select all that apply.
- A. Decreased pain
- B. Increased urinary output
- C. Decreased blood pressure
- D. Decreased temperature
- E. Increased muscle coordination
Correct Answer: A,D
Rationale: Ketorolac, an NSAID, reduces pain and inflammation, which can lower temperature in febrile clients. It does not directly affect urinary output, blood pressure, or muscle coordination.
A client with a large goiter is scheduled for a subtotal thyroidectomy to treat thyrotoxicosis. Saturated solution of potassium iodide (SSKI) is prescribed preoperatively for the client. The primary reason for using this drug is that it helps:
- A. Slow progression of exophthalmos.
- B. Reduce the vascularity of the thyroid gland.
- C. Decrease the body's ability to store thyroxine.
- D. Increase the body's ability to excrete thyroxine.
Correct Answer: B
Rationale: SSKI reduces the vascularity of the thyroid gland, making surgery safer by decreasing the risk of bleeding. It does not primarily affect exophthalmos, thyroxine storage, or excretion.
A client with Parkinson's disease asks the nurse to explain to his nephew "what the doctor said the pallidotomy would do." The nurse's best response includes stating that the main goal for the client after pallidotomy is improved:
- A. Functional ability.
- B. Emotional stress.
- C. Alertness.
- D. Appetite.
Correct Answer: A
Rationale: Pallidotomy aims to improve functional ability by reducing symptoms like tremors and rigidity. Emotional stress, alertness, and appetite are not primary targets of this procedure.