Nokea
A client recently diagnosed with bipolar disorder expresses concern over taking Eskalith (lithium carbonate) because 'a lot of people have problems getting too much of it.' The nurse should explain that lithium toxicity typically occurs when the client has an insufficient intake of:
- A. Carbohydrates for energy
- B. Protein for maintenance of cell integrity
- C. Potassium for muscle contractility
- D. Sodium and fluids for renal excretion
Correct Answer: D
Rationale: Lithium toxicity occurs with insufficient sodium and fluids, as low sodium increases lithium reabsorption in kidneys, and fluids aid excretion. Other nutrients are less directly related.
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A client with angina is experiencing migraine headaches. The physician has prescribed sumatriptan succinate (Imitrex). Which nursing action is most appropriate?
- A. Consult with the RN before administration.
- B. Try to obtain samples for the client to take home.
- C. Perform discharge teaching regarding this drug.
- D. Consult social services for financial assistance with obtaining the drug.
Correct Answer: A
Rationale: Sumatriptan is contraindicated in clients with angina due to its vasoconstrictive effects, which could exacerbate cardiac ischemia. Consulting the RN to verify the order is the most appropriate action. Obtaining samples, discharge teaching, or consulting social services do not address the safety concern, so answers B, C, and D are incorrect.
The nurse is preparing a client with a severe case of inflamed hemorrhoids for a rectal examination by the physician. What is the best position to place her in on the examination table?
- A. Dorsal recumbent
- B. Knee-chest
- C. Sims'
- D. Lithotomy
Correct Answer: B
Rationale: The knee-chest position provides optimal exposure for rectal examination, minimizing discomfort with inflamed hemorrhoids.
The nurse is performing in-service education about the use of the defibrillator.
Which of the following statements, if made by the nurse, is MOST important?
- A. Do not touch the bed when using the defibrillator.
- B. Check the defibrillator every 24 hours.
- C. Do not leave the defibrillator plugged in.
- D. Do not place the paddles over the electrodes.
Correct Answer: A
Rationale: Strategy: Answers are implementations. Determine the outcome of each answer choice. Is it desired? (1) correct-is a priority to prevent accidental countershock (2) equipment should be checked every eight hours (3) equipment should remain plugged in at all times (4) is not a priority; while this should not occur, it can be safely done
Which action by the client indicates an acceptance of his recent amputation?
- A. He verbalizes acceptance.
- B. He looks at the operative site.
- C. He asks for information regarding prosthesis.
- D. He remains silent during dressing changes.
Correct Answer: C
Rationale: Asking about a prosthesis indicates the client is planning for future mobility and adapting to the amputation, a strong sign of acceptance. Verbalizing acceptance is less specific, looking at the site may indicate curiosity or distress, and silence suggests denial or withdrawal.
A nurse is conducting a community wide seminar on childhood safety issues. Which of these children is at the highest risk for poisoning?
- A. 9 month-old who stays with a sitter 5 days a week
- B. 20 month-old who has just learned to climb stairs
- C. 10 year-old who occasionally stays at home unattended
- D. 15 year-old who likes to repair bicycles
Correct Answer: B
Rationale: 20 month-old who has just learned to climb stairs. Increased mobility and curiosity put toddlers at high risk for poisoning.