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A client with a history of atrial fibrillation is prescribed dabigatran (Pradaxa). Which instruction should the nurse include in the client's teaching?
- A. Take the medication with food to improve absorption.
- B. Avoid foods high in vitamin K.
- C. Take the medication at the same time each day.
- D. Increase your intake of high-potassium foods.
Correct Answer: C
Rationale: The correct answer is C: Take the medication at the same time each day. This instruction is crucial for maintaining consistent blood levels of dabigatran, maximizing its effectiveness in preventing blood clots. Taking it at the same time each day helps establish a routine and reduces the risk of missed doses.
Choice A is incorrect because dabigatran should be taken without regard to meals. Choice B is incorrect as vitamin K does not interact with dabigatran. Choice D is incorrect because increasing high-potassium foods is not necessary for dabigatran therapy.
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A 65-year-old female client arrives in the emergency department with shortness of breath and chest pain. The nurse accidentally administers 10 mg of morphine sulfate instead of the prescribed 4 mg. Later, the client's respiratory rate is 10 breaths/minute, oxygen saturation is 98%, and she states her pain has subsided. What is the legal status of the nurse?
- A. The nurse is guilty of negligence and will be sued.
- B. The client would not be able to prove malpractice in court.
- C. The nurse is protected by the Good Samaritan Act.
- D. The healthcare provider should have given the morphine sulfate dose.
Correct Answer: B
Rationale: The correct answer is B: The client would not be able to prove malpractice in court. In this scenario, although the nurse made an error in administering a higher dose of morphine, the client's condition improved, as evidenced by stable vital signs and pain relief. Therefore, there was no harm caused to the client due to the mistake. In malpractice cases, the client needs to prove that harm or injury resulted from the healthcare provider's actions. Since the client's condition improved, it would be difficult to establish malpractice in this situation.
Choice A is incorrect because negligence requires harm or injury to occur, which is not the case here. Choice C is incorrect as the Good Samaritan Act typically applies to individuals providing emergency care in good faith at the scene of an emergency, not within a healthcare setting. Choice D is incorrect as the focus is on the nurse's error in administering the incorrect dose, not on the healthcare provider's responsibility in this context.
A client is being educated about type 2 diabetes. The educator can confirm that the client understands the primary treatment for type 2 diabetes when the client states what?
- A. I read that a pancreas transplant will provide a cure for my diabetes.
- B. I will take my oral antidiabetic agents when my morning blood sugar is high.
- C. I will make sure to follow the weight loss plan designed by the dietitian.
- D. I will make sure I call the diabetes educator when I have questions about my insulin.
Correct Answer: C
Rationale: Correct Answer: C
Rationale:
1. Weight loss helps improve insulin sensitivity.
2. Managing weight is crucial for controlling blood sugar levels.
3. Dietitian-designed plans focus on balanced nutrition for diabetes management.
4. Weight loss can reduce the need for medication and improve overall health.
Summary of Incorrect Choices:
A: Pancreas transplant is not a primary treatment for type 2 diabetes.
B: Taking oral antidiabetic agents based on blood sugar levels is not ideal.
D: Contacting the diabetes educator for insulin questions is important but not primary treatment.
When creating a care plan for a 70-year-old obese client admitted to the postsurgical unit following a colon resection, the client's age and increased body mass index put them at increased risk for which complication in the postoperative period?
- A. Hyperglycemia
- B. Azotemia
- C. Falls
- D. Infection
Correct Answer: D
Rationale: The correct answer is D: Infection. Postoperative obese patients are at higher risk for surgical site infections due to impaired wound healing, decreased tissue oxygenation, and increased tissue pressure. Obesity also compromises the immune system, further increasing susceptibility to infections. Age is a risk factor for infection as well, as older adults may have weakened immune responses. Hyperglycemia (choice A) is a common issue in obese patients but not specifically related to postoperative complications. Azotemia (choice B) refers to elevated levels of nitrogen-containing compounds in the blood and is not directly related to obesity or age. Falls (choice C) are more related to mobility issues and environmental factors, not specifically to age and obesity in the postoperative period.
When working with a client who has chronic constipation, what should be included in client teaching to promote normal bowel function?
- A. Use glycerin suppositories on a regular basis
- B. Limit physical activity in order to promote bowel peristalsis
- C. Consume high-residue, high-fiber foods
- D. Resist the urge to defecate until the urge becomes intense
Correct Answer: C
Rationale: The correct answer is C: Consume high-residue, high-fiber foods. High-fiber foods promote regular bowel movements by adding bulk to the stool, making it easier to pass. Fiber also helps in maintaining bowel health and preventing constipation. Glycerin suppositories (A) should not be used regularly as they can lead to dependence. Limiting physical activity (B) is not recommended as exercise can aid in promoting bowel peristalsis. Resisting the urge to defecate (D) can worsen constipation and lead to complications. In summary, promoting high-fiber diet is the most effective way to help manage chronic constipation.
A client returns to the unit after a neck dissection. The surgeon placed a Jackson-Pratt drain in the wound. When assessing the wound drainage over the first 24 postoperative hours, what finding would prompt the nurse to notify the health care provider immediately?
- A. Presence of small blood clots in the drainage
- B. 60 mL of milky or cloudy drainage
- C. Spots of drainage on the dressings surrounding the drain
- D. 120 mL of serosanguinous drainage
Correct Answer: B
Rationale: The correct answer is B: 60 mL of milky or cloudy drainage. This finding could indicate the presence of an infection, which is a serious complication post-neck dissection. Milky or cloudy drainage may contain pus, indicating the need for immediate intervention to prevent further complications.
A: Presence of small blood clots in the drainage is relatively common and may not necessarily indicate a problem unless there are large clots or excessive bleeding.
C: Spots of drainage on the dressings surrounding the drain are expected and do not necessarily warrant immediate notification unless there is excessive leakage.
D: 120 mL of serosanguinous drainage is within the expected range for the first 24 hours postoperatively and may not be a cause for immediate concern unless there are other symptoms present.