Nokea
A client with a history of chronic kidney disease is admitted with anemia. The nurse should expect to administer which of the following medications?
- A. Epoetin alfa (Epogen).
- B. Ferrous sulfate.
- C. Vitamin B12.
- D. Folic acid.
Correct Answer: A
Rationale: Epoetin alfa stimulates red blood cell production in chronic kidney disease-related anemia.
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A client is prescribed lansoprazole for the chronic management of Zollinger-Ellison syndrome. The nurse determines that the client best understands this disorder and the medication regimen when the client reports taking which product for pain?
- A. Naprosyn
- B. Ibuprofen
- C. Acetaminophen
- D. Acetylsalicylic acid
Correct Answer: C
Rationale: Zollinger-Ellison syndrome is a hypersecretory condition of the stomach. The client should take acetaminophen for pain relief. The client should not take medications that irritate the stomach lining. Irritants would include aspirin and nonsteroidal antiinflammatory medications (naprosyn and ibuprofen).
A client with gastroesophageal reflux disease (GERD) reports chest discomfort that feels like heartburn, especially following each meal. After teaching the client to take antacids as prescribed, the nurse suggests that the client lie in which position during sleep?
- A. Prone with the head of the bed flat
- B. Supine with the head of the bed flat
- C. On the left side with the head of the bed flat
- D. With the head of the bed elevated 8 to 12 inches
Correct Answer: D
Rationale: The discomfort of reflux is aggravated by positions that allow the reflux of gastrointestinal contents. The client is instructed to remain upright for 1 to 2 hours after a meal and sleep with the head of the bed elevated to approximately 30 degrees (usually on 8- to 12-inch blocks). Lying flat will increase the episodes of reflux, resulting in chest discomfort.
The mother of a 7-month-old child born 6 weeks early asks the nurse what play activities and toys are appropriate for her child. Which of the following should the nurse suggest?
- A. Picture books
- B. Peek-a-boo
- C. Rattle
- D. Colored blocks
Correct Answer: B
Rationale: Peek-a-boo is an age-appropriate activity for a 7-month-old, promoting social and cognitive development. Picture books and colored blocks are better for older children, and a rattle may be less engaging for this age.
The nurse performing tracheostomy care has replaced the tracheostomy tube holder (tracheostomy ties). Which is an effective measure for the nurse to use when determining if the holder is not too tight?
- A. The client nods that he or she feels comfortable.
- B. Two fingers can be slid comfortably under the holder.
- C. Four fingers can be slid comfortably under the holder.
- D. The tracheostomy does not move more than 0.5 inch when the client coughs.
Correct Answer: B
Rationale: There should be enough room for two fingers to slide comfortably under the tracheostomy holder. This ensures that the holder is tight enough to prevent tracheostomy dislocation, while preventing excessive constriction around the neck. The other options are incorrect.
A child with the diagnosis of Hirschsprung's disease has a temporary colostomy. The nurse provides instructions to the parents about colostomy care at home. Which statement by the parents indicates their understanding of the instructions?
- A. We will give antidiarrheal medications.
- B. We will report signs of skin breakdown.
- C. We will give saline water enemas if my child doesn't pass stool.
- D. We will apply a heat lamp to any moist red tissue around the stoma.
Correct Answer: B
Rationale: The parents are instructed to report signs of skin breakdown or stomal complications, such as ribbonlike stools or failure to pass flatus or stools, to the primary health care provider or the nurse. Moist, red granulation tissue may grow around an ostomy site and does not require special treatment. The remaining options are incorrect actions and considered contraindicated.