Nokea
A client is to receive Tetracaine before a Bronchoscopy. Which of the following actions should the nurse include in the plan of care?
- A. Keep the client NPO until the pharyngeal response returns.
- B. Monitor the insertion site for a hematoma.
- C. Palpate the bladder to detect urinary retention.
- D. Maintain the client on bed rest for 12 hours following the procedure.
Correct Answer: A
Rationale: The correct action for the nurse to include in the plan of care is to keep the client NPO until the pharyngeal response returns. Tetracaine can affect the gag reflex, so it is important to prevent aspiration by maintaining the client NPO until the pharyngeal response is normal, which typically takes about 1 hour. Monitoring for the return of the gag reflex is crucial to prevent complications from aspiration during the first oral intake after the procedure.
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A healthcare professional is assessing a client during transfusion of a unit of whole blood. The client develops a cough, shortness of breath, elevated blood pressure, and distended neck veins. The healthcare professional should anticipate a prescription for which of the following medications?
- A. Epinephrine
- B. Lorazepam
- C. Furosemide
- D. Diphenhydramine
Correct Answer: C
Rationale: In the scenario described, the client is exhibiting signs of fluid overload, which can occur during blood transfusion. Furosemide, a loop diuretic, is commonly prescribed in such situations to help relieve manifestations of circulatory overload by promoting diuresis and reducing fluid volume. Therefore, the correct choice is C - Furosemide.
A client has a new prescription for methotrexate to treat Rheumatoid Arthritis. The nurse should expect to monitor the client for which of the following adverse effects?
- A. Insomnia
- B. Hypertension
- C. Bone marrow suppression
- D. Constipation
Correct Answer: C
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.
A healthcare provider is caring for a group of individuals who are not immune to Varicella. The healthcare provider should prepare to administer the Varicella vaccine at this time to which of the following individuals?
- A. 24-year-old woman in the third trimester of pregnancy
- B. 12-year-old child who has a severe allergy to neomycin
- C. 2-month-old infant who has no health problems
- D. 32-year-old man who has essential hypertension
Correct Answer: D
Rationale: The correct answer is the 32-year-old man with essential hypertension. Individuals who did not receive two doses of the varicella vaccine earlier in life should be immunized. Essential hypertension is not a contraindication for the varicella vaccine. Administering the vaccine to pregnant women, individuals with severe neomycin allergies, or infants is contraindicated.
A healthcare professional is providing discharge instructions to a client who has a new prescription for Furosemide. Which of the following instructions should the healthcare professional include?
- A. Take the medication with breakfast.
- B. Increase intake of foods high in potassium.
- C. Avoid prolonged sun exposure.
- D. Limit sodium intake.
Correct Answer: B
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.
A client prescribed Isosorbide Mononitrate for chronic stable Angina develops reflex tachycardia. Which of the following medications should the nurse expect to administer?
- A. Furosemide
- B. Captopril
- C. Ranolazine
- D. Metoprolol
Correct Answer: D
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.