Nokea
A client with a history of chronic obstructive pulmonary disease (COPD) is prescribed prednisone. The nurse should monitor the client for which of the following adverse effects?
- A. Hyperglycemia.
- B. Hypotension.
- C. Weight loss.
- D. Bradycardia.
Correct Answer: A
Rationale: Prednisone can cause hyperglycemia, requiring blood glucose monitoring.
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The nurse is reviewing the client's arterial blood gas results. Which finding would indicate that the client is experiencing respiratory acidosis?
- A. pH 7.5, PcO2 of 30
- B. pH 7.3, PcO2 of 50
- C. pH 7.3, HCO3 of 19
- D. pH 7.5, HCO3 of 30
Correct Answer: B
Rationale: In respiratory acidosis, the pH is decreased and an opposite effect is seen in the PCO2 (pH decreased, PCO2 elevated). Option 1 indicates respiratory alkalosis; option 3 indicates possible metabolic acidosis; option 4 indicates possible metabolic alkalosis.
The nurse is caring for a client with a history of chronic obstructive pulmonary disease who is prescribed fluticasone (Flovent). The nurse should instruct the client to:
- A. Use the inhaler as needed for shortness of breath.
- B. Rinse the mouth after using the inhaler.
- C. Shake the inhaler before use.
- D. Take two puffs twice daily.
Correct Answer: B
Rationale: Rinsing the mouth after using fluticasone prevents oral candidiasis, a common side effect of inhaled corticosteroids.
When performing chest percussion on a child, which of the following techniques should the nurse use?
- A. Firmly but gently striking the chest wall to make a popping sound.
- B. Gently striking the chest wall to make a slapping sound.
- C. Percussing over an area from the umbilicus to the clavicle.
- D. Placing a blanket between the nurse's hand and the child's chest.
Correct Answer: A
Rationale: Chest percussion involves firmly but gently striking the chest to produce a popping sound, mobilizing secretions without causing harm.
Methylergonovine maleate is prescribed for a woman who has just delivered a healthy newborn. Which is the priority assessment to complete before administering the medication?
- A. Lochia
- B. Uterine tone
- C. Blood pressure
- D. Deep tendon reflexes
Correct Answer: C
Rationale: Methylergonovine maleate, an oxytocic, is an agent used to prevent or control postpartum hemorrhage by contracting the uterus. The immediate dose is administered intramuscularly, and then, if still needed, it is administered orally. It causes uterine contractions and may elevate the blood pressure. A priority assessment before administration of methylergonovine maleate is blood pressure. Methylergonovine maleate is to be administered cautiously in the presence of hypertension, and the primary health care provider should be notified if hypertension is present. Options 1 and 2 are general components of care in the postpartum period. Option 4 is most specifically related to the administration of magnesium sulfate.
The nurse is providing instructions to the parent of a child who had a myringotomy with insertion of tympanostomy tubes. Which instructions should the nurse provide the parent in case the tubes fall out?
- A. Bring the child to the emergency department immediately.
- B. It is not an emergency, but it is best to call the health care clinic.
- C. It is important to replace them immediately so that the surgical opening does not close.
- D. Clean the tubes with half-strength hydrogen peroxide for 30 minutes and then replace them into the child's ears.
Correct Answer: B
Rationale: The parent should be assured that if the tympanostomy tubes fall out, it is not an emergency, but it is best if the primary health care provider or health care clinic is notified. The size and appearance of the tympanostomy tubes should be described to the parent after surgery so that he or she will be familiar with their appearance. The remaining options are incorrect.