Nokea
A client with a diagnosis of Tourette's syndrome is receiving haloperidol decanoate. The registered nurse asks the new nurse to describe the action of the medication. The new nurse responds correctly by stating that this medication has which action?
- A. Is a serotonin reuptake blocker
- B. Inhibits the breakdown of released acetylcholine
- C. Blocks the uptake of norepinephrine and serotonin
- D. Blocks the binding of dopamine to the postsynaptic dopamine receptors in the brain
Correct Answer: D
Rationale: Haloperidol decanoate is a typical antipsychotic medication used to manage symptoms of Tourette's syndrome, such as tics, by blocking the binding of dopamine to postsynaptic dopamine receptors in the brain, thereby reducing dopaminergic activity. It does not act as a serotonin reuptake blocker, inhibit acetylcholine breakdown, or block norepinephrine and serotonin uptake.
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Which of the following correctly describes Medicaid?
- A. A program designed to assist ill, low-income older adults.
- B. A federal insurance program for pregnant women.
- C. A joint federal-state program for low-income persons.
- D. A program administered by health maintenance organizations.
Correct Answer: C
Rationale: Medicaid is a joint federal-state program providing healthcare coverage for low-income individuals, including children, pregnant women, and the elderly.
The nurse is preparing to give a subcutaneous injection to an elderly, emaciated client. Which needle length and angle should the nurse plan to use to administer the injection safely?
- A. A 3/8-inch needle at a 90-degree angle.
- B. A 3/8-inch needle at a 45-degree angle.
- C. A 1/2-inch needle at a 15-degree angle.
- D. A 5/8-inch needle at a 90-degree angle.
Correct Answer: B
Rationale: For an emaciated client, a 3/8-inch needle at a 45-degree angle ensures subcutaneous delivery without hitting muscle or bone.
The nurse providing care to a client with a leg fracture ensures that which intervention is first implemented before the fracture is reduced in the casting room?
- A. Obtaining an anesthesia consent
- B. Administering an opioid analgesic
- C. Notifying the operating room staff
- D. Obtaining an informed consent for treatment
Correct Answer: D
Rationale: Before a fracture is reduced, an informed consent for treatment is needed. The nurse should reinforce explanations according to the client's needs and ability to understand. Administration of anesthesia would only be done in the operating room for open reduction of fractures. Closed reductions may be done in the emergency department without anesthesia. An analgesic would be administered as prescribed because the procedure is painful, but the informed consent form must be obtained before administering the medication.
Select the hazard of immobility that is accurately paired with an appropriate expected outcome of care that the nurse provides to prevent this complication.
- A. Bone demineralization: Turning and positioning every 2 hours
- B. Urinary stasis: The client will consume 1,000 mL of oral fluids per day
- C. Muscle atrophy: The client will perform range of motion exercises at least 3 times a day
- D. Hypercalcemia: Maintaining fluid intake of 1,000 mL per day
Correct Answer: C
Rationale: Range of motion exercises prevent muscle atrophy by maintaining muscle strength and function in immobile clients.
Clozapine (Clozaril) therapy has been initiated for a client with schizophrenia who has been unresponsive to other antipsychotics. The client states, 'Why do I have to have a blood test every week?' Which of the following responses by the nurse would be most appropriate?
- A. Weekly blood tests are necessary to determine safe dosage and to monitor the effect of the medication on the blood.'
- B. Weekly blood tests are done so that you can receive another week's supply of the medication.'
- C. Your physician will want to know how well you are personally progressing with the medication therapy.'
- D. Everyone who takes this drug must go through the same procedure because it is required by the drug company.'
Correct Answer: A
Rationale: Weekly blood tests monitor for agranulocytosis, a serious side effect of clozapine, ensuring safe dosing and early detection of blood abnormalities.