Nokea
A client with a history of chronic kidney disease (CKD) is being discharged with a prescription for epoetin alfa (Epogen). What should the nurse include in the discharge teaching?
- A. Take this medication on an empty stomach.
- B. Monitor your blood pressure regularly.
- C. Expect to feel better immediately.
- D. Avoid foods high in potassium.
Correct Answer: B
Rationale: The correct answer is B: 'Monitor your blood pressure regularly.' Epoetin alfa (Epogen) can lead to hypertension as a side effect, so it is essential for clients with CKD to monitor their blood pressure regularly. Choice A is incorrect because epoetin alfa does not need to be taken on an empty stomach. Choice C is incorrect because the client should not expect immediate improvement upon starting the medication. Choice D is incorrect because while monitoring potassium intake is important in CKD, the question specifically pertains to epoetin alfa and its side effects, not potassium intake.
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The nurse observes a client with new-onset tachycardia. What should the nurse do first?
- A. Check for the client's temperature
- B. Administer prescribed beta-blockers
- C. Assess for any chest pain or discomfort
- D. Monitor the client's blood pressure
Correct Answer: C
Rationale: When a client presents with new-onset tachycardia, the first action the nurse should take is to assess for any associated symptoms like chest pain or discomfort. This is important to differentiate the potential causes of tachycardia and guide appropriate interventions. Checking the client's temperature (Choice A) may be relevant in certain situations but is not the priority when tachycardia is observed. Administering prescribed beta-blockers (Choice B) should only be done after a comprehensive assessment and healthcare provider's orders. Monitoring the client's blood pressure (Choice D) is important, but assessing for chest pain or discomfort takes precedence in this scenario to rule out cardiac causes of tachycardia.
A client with a history of atrial fibrillation is prescribed warfarin. Which lab value should the nurse monitor to assess the effectiveness of this medication?
- A. Hemoglobin
- B. White blood cell count
- C. Platelet count
- D. INR
Correct Answer: D
Rationale: The correct answer is D, INR (International Normalized Ratio). The INR is used to monitor the effectiveness of warfarin therapy. Warfarin is an anticoagulant medication commonly prescribed for conditions like atrial fibrillation. Monitoring the INR helps healthcare providers ensure that the blood is clotting within a therapeutic range. Hemoglobin (Choice A), white blood cell count (Choice B), and platelet count (Choice C) are not directly related to monitoring the effectiveness of warfarin therapy in this context.
Which nonfood item is the most common cause of respiratory arrest in young children?
- A. Broken rattles
- B. Buttons
- C. Pacifiers
- D. Latex balloons
Correct Answer: D
Rationale: The correct answer is D, Latex balloons. Latex balloons can pose a significant choking hazard to young children if inhaled, potentially leading to respiratory arrest. Broken rattles, buttons, and pacifiers are not typically known to cause respiratory arrest in young children. While these items can present choking hazards as well, the most common cause of respiratory arrest among young children is due to inhaling latex balloons.
During a bed bath, the nurse observes that a client's IV site is red and swollen. What should the nurse do first?
- A. Discontinue the IV under physician's guidance
- B. Apply a warm compress to the site
- C. Notify the physician
- D. Document the appearance of the site and continue the bath
Correct Answer: C
Rationale: The correct first action when a nurse observes a red and swollen IV site during a bed bath is to notify the physician. This is crucial because prompt reporting allows for immediate intervention to prevent further complications. Discontinuing the IV (Choice A) should only be done under the physician's guidance to avoid any adverse effects and ensure proper care. Applying a warm compress (Choice B) may not address the underlying issue and could potentially worsen the situation if the cause is an infection or infiltration. Documenting the site's appearance and continuing the bath (Choice D) without immediate action might delay necessary treatment, leading to potential complications.
A client with diabetes mellitus is admitted with hyperglycemia. What is the priority nursing action?
- A. Administer insulin as prescribed
- B. Encourage fluid intake
- C. Monitor blood glucose levels frequently
- D. Assess for signs of hypoglycemia
Correct Answer: A
Rationale: Administering insulin is the priority nursing action for a client admitted with hyperglycemia due to diabetes mellitus. Insulin helps lower blood glucose levels and prevent further complications associated with hyperglycemia. Encouraging fluid intake is important but not the priority as insulin administration takes precedence to address the immediate hyperglycemic state. Monitoring blood glucose levels frequently is essential but comes after administering insulin to ensure the treatment's effectiveness. Assessing for signs of hypoglycemia is incorrect as the client is admitted with hyperglycemia, which requires raising blood glucose levels, not lowering them further.