Nokea
A client with a history of a peptic ulcer is receiving Zantac (ranitidine). The nurse should teach the client to:
- A. Take the medication with meals
- B. Avoid caffeine
- C. Monitor for chest pain
- D. Increase fluid intake
Correct Answer: B
Rationale: Caffeine can exacerbate peptic ulcers by increasing gastric acid production, counteracting ranitidine’s effects. Ranitidine is taken regardless of meals, and chest pain or fluids are secondary.
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The nurse is performing an admission history for a client recovering from a stroke. Medication history reveals the drug clopidogrel (Plavix). Which clinical manifestation alerts the nurse to an adverse effect of this drug?
- A. Epistaxis
- B. Hypothermia
- C. Nausea
- D. Hyperactivity
Correct Answer: A
Rationale: Clopidogrel, an antiplatelet, increases bleeding risk. Epistaxis (nosebleed) is a significant adverse effect. Hypothermia (B), nausea (C), and hyperactivity (D) are not associated with clopidogrel.
The client is admitted with left-sided congestive heart failure. In assessing the client for edema, the nurse should check the:
- A. Feet
- B. Neck
- C. Hands
- D. Sacrum
Correct Answer: D
Rationale: In left-sided congestive heart failure, fluid backs up into the lungs, but dependent edema is assessed in the sacrum in bedridden clients or feet in ambulatory clients. The sacrum is the most appropriate site for hospitalized clients, as they are often recumbent.
Following TURP, which of the following instructions would be appropriate to prevent or alleviate anxiety concerning the client's sexual functioning?
- A. You may resumption sexual intercourse in 2 weeks.'
- B. Many men experience impotence following TURP.'
- C. A transurethral resection does not usually cause impotence.'
- D. Check with your doctor about resuming sexual activity.'
Correct Answer: C
Rationale: Although the client may experience retrograde ejaculation, it will not limit his ability to engage in sexual intercourse.
The nurse is caring for a client with a closed head injury. Which finding should be reported to the doctor immediately?
- A. Urine output of 50 mL per hour
- B. Blood pressure of 148/92
- C. Respiratory rate of 16 breaths per minute
- D. Pupils that are unequal
Correct Answer: D
Rationale: Unequal pupils suggest increased intracranial pressure or neurological deterioration in a head injury, requiring immediate reporting. The other findings are within normal or less urgent ranges.
A client with a right lobectomy is being transported from the intensive care unit to a medical unit. The nurse understands that the client's chest drainage system:
- A. Can be disconnected from suction if the chest tube is clamped
- B. Can be disconnected from suction, but the chest tube should remain unclamped
- C. Must remain connected by means of a portable suction
- D. Must be kept even with the client's shoulders during the transport
Correct Answer: B
Rationale: The chest drainage system can be disconnected from suction during transport, but the tube must remain unclamped to allow air or fluid to escape, preventing pneumothorax. Portable suction is not always needed.