Nokea
A client with a history of chronic pain is prescribed gabapentin (Neurontin). The nurse should instruct the client to report which of the following side effects?
- A. Drowsiness.
- B. Hypertension.
- C. Hyperglycemia.
- D. Tachycardia.
Correct Answer: A
Rationale: Gabapentin commonly causes drowsiness, which should be reported to manage safety and dosing.
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The nurse is assessing a client who has had a myocardial infarction. The nurse notes the cardiac rhythm shown below (see figure). The nurse identifies this rhythm as:
- A. Atrial fibrillation.
- B. Atrial tachycardia.
- C. Premature ventricular contractions.
- D. Ventricular tachycardia.
Correct Answer: C
Rationale: Premature ventricular contractions (PVCs) are characterized by early, wide QRS complexes on an ECG, common post-myocardial infarction. The other rhythms have distinct ECG patterns not described here.
A client's medical record states a history of intermittent claudication. In collecting data about this symptom, the nurse should ask the client about which symptom?
- A. Chest pain that is dull and feels like heartburn
- B. Leg pain that is sharp and occurs with exercise
- C. Chest pain that is sudden and occurs with exertion
- D. Leg pain that is achy and gets worse as the day progresses
Correct Answer: B
Rationale: Intermittent claudication is a symptom characterized by a sudden onset of leg pain that occurs with exercise and is relieved by rest. It is the classic symptom of peripheral arterial insufficiency. Chest pain can occur for a variety of reasons, including indigestion or angina pectoris. Venous insufficiency is characterized by an achy type of leg pain that intensifies as the day progresses.
An infant is brought to the clinic for a regular checkup and the diphtheria, tetanus, and acellular pertussis (DTaP) and inactivated polio vaccine (IPV) immunizations. The child is recovering from a cold and is afebrile. The child's sibling has cancer and is receiving chemotherapy. Which of the following actions is most appropriate?
- A. Giving the DTaP and withholding the IPV.
- B. Administering the DTaP and IPV immunizations.
- C. Postponing both immunizations until the sibling is in remission.
- D. Withholding both immunizations until the infant is well.
Correct Answer: B
Rationale: The infant is afebrile and recovering, and neither DTaP nor IPV is live vaccines, so they are safe to administer despite the sibling's immunocompromised state.
The nurse is caring for a client with a diagnosis of deep vein thrombosis (DVT). Which of the following interventions is most appropriate?
- A. Applying cold packs to the affected leg.
- B. Encouraging ambulation every hour.
- C. Administering heparin as ordered.
- D. Elevating the leg above heart level.
Correct Answer: C,D
Rationale: Heparin prevents clot extension in DVT, and elevating the leg reduces swelling and promotes venous return.
A client experiencing a mild panic attack has the following arterial blood gas (ABG) results: pH 7.49, PCO2 31 mm Hg, PaO2 97 mm Hg, HCO3 22 mEq/L. The nurse reviews the results and determines that the client has which acid-base disturbance?
- A. Metabolic acidosis
- B. Metabolic alkalosis
- C. Respiratory acidosis
- D. Respiratory alkalosis
Correct Answer: D
Rationale: Acidosis is defined as a pH of less than 7.35, whereas alkalosis is defined as a pH of greater than 7.45. Respiratory alkalosis is present when the PCO2 is less than 35, whereas respiratory acidosis is present when the PCO2 is greater than 45. Metabolic acidosis is present when the HCO3 is less than 22 mEq/L, whereas metabolic alkalosis is present when the HCO3 is greater than 26 mEq/L. This client's ABGs are consistent with respiratory alkalosis.