Nokea
A client recently diagnosed with atrial fibrillation is being discharged home on digoxin (Lanoxin). The nurse is providing education to the client and family. Which client statement indicates the need for further teaching?
- A. I should take my medicine at the same time each day.
- B. If I miss a dose, I can take it as soon as I remember it.
- C. I need to call my doctor if my heart rate goes below 60 or above 110.
- D. Changes in my vision could be toxicity and should be reported immediately.
Correct Answer: B
Rationale: Taking a missed digoxin dose as soon as remembered is incorrect; clients should skip it if it’s close to the next dose to avoid toxicity. Other statements reflect correct understanding.
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The physician has prescribed Gantrisin (sulfasoxazole) 1 g in divided doses for a client with a urinary tract infection. The nurse should administer the medication:
- A. With meals or a snack
- B. 30 minutes before meals
- C. 30 minutes after meals
- D. At bedtime
Correct Answer: A
Rationale: Gantrisin should be taken with food to reduce gastrointestinal upset, and adequate fluid intake is needed to prevent crystalluria.
A client with cancer is to undergo a bone scan. The nurse should:
- A. Force fluids 24 hours before the procedure
- B. Ask the client to void immediately before the study
- C. Hold medication that affects the central nervous system for 12 hours pre- and post-test
- D. Cover the client's reproductive organs with an x-ray shield
Correct Answer: B
Rationale: Voiding immediately before a bone scan ensures the bladder is empty, reducing interference with pelvic imaging and improving the accuracy of the scan.
A nurse needs to draw a blood sample from a patient's central line. The line is currently infusing Ringer's lactate. In which order should the nurse take the following steps to draw the blood sample? Number the steps below.
- A. attach the flush syringe and flush catheter with normal saline
- B. stop the infusion and disconnect Ringer's lactate
- C. withdraw a blood sample and discard
- D. scrub the catheter hub
- E. withdraw the blood sample for the lab
Correct Answer: B,D,C,A,E
Rationale: Order: Stop infusion (B), scrub hub (D), withdraw/discard blood (C), flush with saline (A), withdraw lab sample (E). This ensures a clean, accurate sample.
A client's lab results have just come in. The nurse reviews the electrolytes and contacts the health care provider regarding which result?
- A. chloride 167 mEq/L
- B. calcium 9.3 mg/dL
- C. phosphate 3.8 mg/dL
- D. sodium 141 mEq/L
Correct Answer: A
Rationale: Chloride 167 mEq/L is severely elevated (normal 98-106 mEq/L), requiring immediate attention. Other values are normal.
A client with cancer is to undergo an intravenous pyelogram. The nurse should:
- A. Force fluids 24 hours before the procedure
- B. Ask the client to void immediately before the study
- C. Hold medication that affects the central nervous system for 12 hours pre- and post-test
- D. Cover the client's reproductive organs with an x-ray shield.
Correct Answer: B
Rationale: Voiding immediately before an IVP ensures the bladder is empty, improving visualization of the urinary tract.