Nokea
A client with a history of chronic obstructive pulmonary disease (COPD) is admitted with an exacerbation. The nurse should administer which of the following as prescribed?
- A. Oxygen at 2 L/min via nasal cannula.
- B. Albuterol via nebulizer.
- C. Furosemide intravenously.
- D. Morphine for respiratory distress.
Correct Answer: A, B
Rationale: Low-flow oxygen (2 L/min) and albuterol relieve hypoxemia and bronchospasm in COPD exacerbation.
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A client returning from the postanesthesia care unit after transurethral resection of the prostate (TURP) has bladder irrigation running via a 3-way Foley catheter. The nurse should notify the primary health care provider if which color of urine is noted in the urinary drainage bag?
- A. Pale pink
- B. Bright red
- C. Dark pink
- D. Tea-colored
Correct Answer: B
Rationale: Bright red bleeding should be reported because it could indicate complications related to active bleeding. If the bladder irrigation is infusing at a sufficient rate, the urinary drainage will be pale pink. A dark pink color (sometimes referred to as punch-colored) indicates that the speed of the irrigation should be increased. Tea-colored urine is not seen after TURP but may be noted in the client with renal failure or other renal disorders.
Assessment of a nulligravid client in active labor reveals the following: complaints of moderate discomfort; cervix dilated $3 \mathrm{~cm}, 0$ station and completely effaced; fetal heart rate of $136 \mathrm{bpm}$. Which of the following should the nurse plan to do next?
- A. Assist the client with comfort measures and breathing techniques.
- B. Turn the client from the left side-lying position to the right side-lying position.
- C. Prepare the client for epidural anesthesia to relieve pain.
- D. Instruct the client that internal fetal monitoring is necessary.
Correct Answer: A
Rationale: Moderate discomfort in early labor is managed with non-pharmacologic comfort measures and breathing techniques to promote coping.
Allopurinol (Zyloprim) is prescribed for a client who has chronic gout. Which of the following comments indicates that the client understands how to take the allopurinol?
- A. I will take the medication whenever my joints hurt.'
- B. I must take this drug on an empty stomach.'
- C. I should drink plenty of fluids when taking allopurinol.'
- D. I should not take aspirin when taking allopurinol.'
Correct Answer: C
Rationale: Drinking plenty of fluids prevents uric acid crystal formation, enhancing allopurinol's effectiveness in managing gout.
A client has been diagnosed with Bell's palsy. The nurse assesses the client to determine if which signs/symptoms are present?
- A. Eye paralysis and ptosis of the eyelids
- B. Chewing difficulties and one-sided facial droop
- C. Fixed pupil and an elevated eyelid on one side
- D. Twitching of one side of the face and ruddy cheeks
Correct Answer: B
Rationale: Bell's palsy is a one-sided facial paralysis resulting from compression of the facial nerve (CN VII). There is facial droop from paralysis of the facial muscles; increased lacrimation; painful sensations in the eye, face, or behind the ear; and chewing difficulties. The other items listed are not associated with this disorder.
A client with a history of tuberculosis is prescribed isoniazid (INH). The nurse should monitor the client for which of the following adverse effects?
- A. Hepatotoxicity.
- B. Hypoglycemia.
- C. Hypertension.
- D. Weight loss.
Correct Answer: A
Rationale: Isoniazid can cause hepatotoxicity, requiring regular liver function monitoring.