Nokea
A client with a history of a thyroidectomy is receiving Calcitonin (Miacalcin). The nurse should monitor the client for:
- A. Hypocalcemia
- B. Hyperglycemia
- C. Hypotension
- D. Weight gain
Correct Answer: A
Rationale: Calcitonin lowers serum calcium, risking hypocalcemia, requiring monitoring for symptoms like tingling. Hyperglycemia, hypotension, and weight gain are not primary concerns.
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The nurse is teaching a client with a new colostomy about dietary management. Which food should the client avoid to reduce odor?
- A. Broccoli
- B. Rice
- C. Chicken
- D. Yogurt
Correct Answer: A
Rationale: Broccoli, a cruciferous vegetable, increases colostomy odor due to sulfur compounds. Rice (B), chicken (C), and yogurt (D) are odor-neutral and appropriate.
The RN on the oncology unit is preparing to mix and administer amphoteracin B (Fungizone) to a client. Which action is contraindicated for administering this drug IV?
- A. Mix the drug with normal saline solution.
- B. Administer the drug over 4-6 hours.
- C. Hydrate with IV fluids two hours before the infusion is scheduled to begin.
- D. Premedicate the client with ordered acetaminophen (Tylenol) and diphenhydramine (Benadryl).
Correct Answer: A
Rationale: Amphotericin B should be mixed with D5W, not normal saline, due to stability issues. Slow infusion (B), hydration (C), and premedication (D) are standard practices.
The nurse is preparing to administer a dose of warfarin (Coumadin). The client’s INR is 3.5. What action should the nurse take?
- A. Administer the dose as ordered.
- B. Withhold the dose and notify the physician.
- C. Double the dose to achieve therapeutic range.
- D. Administer half the dose.
Correct Answer: B
Rationale: An INR of 3.5 is above the therapeutic range (2–3 for most conditions), indicating increased bleeding risk. The nurse should withhold the dose and notify the physician for further orders. Adjusting the dose independently is unsafe.
Which of the following findings would be expected in the infant with biliary atresia?
- A. Rapid weight gain and hepatomegaly
- B. Dark stools and poor weight gain
- C. Abdominal distention and poor weight gain
- D. Abdominal distention and rapid weight gain
Correct Answer: C
Rationale: Biliary atresia causes bile flow obstruction, leading to abdominal distention (from hepatomegaly) and poor weight gain due to malabsorption. Stools are pale, not dark, and weight gain is not rapid.
Which behavior by a female client feeding her newborn demonstrates that she needs more teaching related to safety and infant feeding?
- A. She uses the bulb syringe to help clear her baby's nose when milk is regurgitated.
- B. She places her infant on her right side after feeding her.
- C. She props the bottle in the crib to feed her baby, which allows her to write birth announcements and feed her baby at the same time.
- D. She burps her baby by placing her in a sitting position, supporting her head and neck and gently massaging her back.
Correct Answer: C
Rationale: This practice is the proper use of the bulb syringe to clear the infant's airway in case of regurgitation. Placing the infant on either side or on the stomach prevents aspiration of regurgitated milk. 'Bottle propping' is an unsafe practice because it increases the likelihood of aspiration. This practice is one correct way of burping an infant.