Nokea
A client who is postop following a knee arthroplasty is concerned about the adverse effects of the medication he is receiving for pain management. Which of the following members of the interprofessional care team may assist the client in understanding the medication's effects? Select all.
- A. Provider
- B. CNA
- C. Pharmacist
- D. RN
- E. Respiratory therapist
Correct Answer: A, C, D
Rationale: The correct answer is A, C, and D. The provider, pharmacist, and RN are key members of the interprofessional care team who can assist the client in understanding the medication's effects. The provider can explain the rationale for prescribing the medication and address any concerns the client may have. The pharmacist can provide detailed information about the medication, including potential side effects and interactions. The RN can monitor the client's response to the medication, educate them on how to take it properly, and address any immediate concerns. Choices B, E, and F are incorrect because CNAs and respiratory therapists typically do not have the expertise to provide in-depth medication counseling to clients.
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A nurse is assessing a client who reports pain when the nurse evaluates the internal rotation of her right shoulder. Which of the following activities is this problem likely to affect?
- A. Mopping her floors
- B. Brushing the back of her hair
- C. Fastening her bra behind her back
- D. Reaching into a cabinet above her sink
Correct Answer: C
Rationale: The correct answer is C. Fastening her bra behind her back. Internal rotation of the shoulder is necessary for this activity as it involves reaching the arm behind the body. Mopping the floors (A) and brushing the back of her hair (B) primarily require shoulder abduction and flexion. Reaching into a cabinet above the sink (D) involves shoulder flexion and abduction, not internal rotation.
A nurse educator is conducting a parenting class for new parents. Which of the following statements made by a participant indicates a need for further clarification & instruction?
- A. I will begin swimming lessons as soon as my baby can close her mouth under water.'
- B. Once my baby can sit up, he should be safe in the bathtub.'
- C. I will test the temp of the water before placing my baby in the bath.'
- D. Once my infant starts to push up, I will remove the mobile from over the bed.'
Correct Answer: B
Rationale: The correct answer is B: "Once my baby can sit up, he should be safe in the bathtub." This statement indicates a need for further clarification because infants are not safe to be left unattended in the bathtub even if they can sit up. They are still at risk of drowning. It is essential for the caregiver to always supervise the baby closely during bath time to ensure their safety. Testing the water temperature (Choice C) and removing the mobile from over the bed (Choice D) are appropriate safety measures. Beginning swimming lessons when the baby can close her mouth under water (Choice A) may be premature but not necessarily dangerous.
A nurse is preparing to administer lactated Ringer's (LR) IV 100 mL over 15 minutes. The nurse should set the infusion pump to deliver how many mL/hr?
Correct Answer: 400
Rationale: The correct answer is 400 mL/hr. To calculate the mL/hr rate, we first convert the 15 minutes to hours (15 minutes ÷ 60 minutes = 0.25 hours). Then, we divide the total volume (100 mL) by the time in hours (100 mL ÷ 0.25 hours = 400 mL/hr). This rate ensures the safe and accurate administration of 100 mL of LR over a 15-minute period. Other choices are incorrect because they do not accurately calculate the mL/hr rate based on the given parameters.
A nurse is reviewing the reported medications of a client who was recently admitted. The medications include cimetidine (Tagamet) and imipramine hydrochloride (Tofranil). Knowing that cimetidine decreases the metabolism of imipramine hydrochloride, the nurse should identify that this combination is likely to result in which of the following effects?
- A. Decreased therapeutic effects of cimetidine
- B. Increased risk of imipramine hydrochloride toxicity
- C. Decreased risk of adverse effects of cimetidine
- D. Increased therapeutic effects of imipramine hydrochloride
Correct Answer: B
Rationale: The correct answer is B: Increased risk of imipramine hydrochloride toxicity. Cimetidine inhibits the metabolism of imipramine hydrochloride, leading to increased levels of imipramine in the body. This can result in a higher concentration of imipramine, potentially causing toxicity. This interaction is known as a pharmacokinetic drug-drug interaction.
Incorrect choices:
A: Decreased therapeutic effects of cimetidine - This is incorrect because cimetidine's therapeutic effects are not directly impacted by its interaction with imipramine.
C: Decreased risk of adverse effects of cimetidine - This is incorrect as there is no evidence to suggest that the interaction with imipramine decreases the risk of adverse effects of cimetidine.
D: Increased therapeutic effects of imipramine hydrochloride - This is incorrect as the increased risk of toxicity does not equate to increased therapeutic effects.
A nurse is caring for a client who is receiving continuous enteral feedings. What is the highest priority intervention when the nurse suspects aspiration?
- A. Auscultate breath sounds.
- B. Stop the feeding.
- C. Obtain a chest x-ray.
- D. Initiate oxygen therapy.
Correct Answer: B
Rationale: The correct answer is B: Stop the feeding. Aspiration can lead to serious complications such as pneumonia. Stopping the feeding immediately is crucial to prevent further aspiration and minimize harm to the client. Auscultating breath sounds (choice A) is important but should be done after stopping the feeding. Obtaining a chest x-ray (choice C) may be necessary later for further evaluation but is not the highest priority in this situation. Initiating oxygen therapy (choice D) may be needed depending on the client's condition, but it is not the highest priority when aspiration is suspected.