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A client who has been taking carisoprodol (Soma) at home for a fractured arm is admitted with a blood pressure of 80/50 mm Hg, a pulse rate of 115 bpm, and respirations of 8 breaths/minute and shallow. The nurse interprets these findings as indicating which of the following?
- A. Expected common adverse effects.
- B. Hypersensitivity reaction.
- C. Possible habituating effect.
- D. Hemorrhage from gastrointestinal irritation.
Correct Answer: B
Rationale: These vital signs suggest a hypersensitivity reaction, a serious adverse effect of carisoprodol.
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To reduce the risk of dumping syndrome, the nurse should teach the client to do which of the following?
- A. Sit upright for 30 minutes after meals.
- B. Drink liquids with meals, avoiding caffeine.
- C. Avoid milk and other dairy products.
- D. Decrease the carbohydrate content of meals.
Correct Answer: D
Rationale: Decreasing carbohydrate content helps slow gastric emptying, reducing the risk of dumping syndrome. Sitting upright is helpful but less specific, and drinking liquids with meals can worsen symptoms.
A client with advanced Hodgkin's disease is admitted to hospice because death is imminent. The goal to address for the client is:
- A. Fear of pain.
- B. Fear of further therapy.
- C. Feelings of isolation.
- D. Feelings of social inadequacy.
Correct Answer: A
Rationale: In hospice care for advanced Hodgkin's disease, the primary goal is to address fear of pain, ensuring comfort as death approaches. Fear of therapy, isolation, and social inadequacy are less relevant at this stage.
A client with an ileal conduit reports a bulging stoma. The nurse suspects:
- A. Stoma retraction.
- B. Parastomal hernia.
- C. Stoma ischemia.
- D. Infection.
Correct Answer: B
Rationale: A bulging stoma suggests a parastomal hernia, a complication requiring evaluation.
The nurse is reviewing the chart of a 55-year-old male client who is scheduled for a lumbar laminectomy. The nurse should report which of the following to the surgeon?
- A. Pimple on the lower back.
- B. Abnormal electrocardiogram (ECG).
- C. Hearing aid.
- D. Allergy to iodine.
Correct Answer: B
Rationale: An abnormal ECG indicates potential cardiac issues that could affect surgical safety under anesthesia. This must be reported to the surgeon for further evaluation. A pimple, hearing aid, or iodine allergy, while notable, are less immediately critical unless directly related to the procedure.
The client with Addison's disease is taking glucocorticoids. Which of the following statements indicates that the client understands how to take the medication?
- A. Various circumstances increase the need for glucocorticoids, so I will need to adjust the dosage.'
- B. My need for glucocorticoids will stabilize and I will be able to take a predetermined dose once a day.'
- C. Glucocorticoids are cumulative, so I will take a dose every third day.'
- D. I must take a dose every 6 hours to ensure consistent blood levels of glucocorticoids.'
Correct Answer: A
Rationale: Glucocorticoid needs vary with stress, requiring dose adjustments in Addison's disease to prevent adrenal crisis.