Nokea
A client with a history of depression is prescribed duloxetine (Cymbalta). The nurse should instruct the client to report which of the following side effects immediately?
- A. Mild headache.
- B. Increased blood pressure.
- C. Nausea.
- D. Fatigue.
Correct Answer: B
Rationale: Duloxetine can cause increased blood pressure, requiring immediate reporting to prevent cardiovascular complications.
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You have been conducting a weekly outpatient stress management educational series for clients in the community who are hypertensive. The best way to evaluate the effectiveness of this educational series is to:
- A. Collect baseline blood pressure readings prior to the beginning of this educational series and then collect and compare blood pressure data during the series and after the series is completed.
- B. Collect baseline blood pressure readings prior to the beginning of this educational series and then collect and compare blood pressure data after the series is completed.
- C. Ask the clients how often they use the stress management techniques that they have learned during this educational series.
- D. Use a questionnaire at the end of the series that asks the participants how they liked the class and what they learned during this educational series.
Correct Answer: A
Rationale: Collecting and comparing blood pressure data before, during, and after the series provides objective evidence of the program's effectiveness in managing hypertension.
When creating a program to decrease the primary cause of disability and death in children, which of the following is most effective for the community health nurse to do?
- A. Encourage state legislators to draft legislation to promote prenatal care.
- B. Recommend that the health department make immunizations available at no cost to all children.
- C. Teach health and safety practices to children and their parents.
- D. Have a nurse practitioner hired for each of the schools in the community.
Correct Answer: B
Rationale: Free immunizations address the leading cause of preventable childhood disability and death by ensuring widespread protection against infectious diseases.
The nurse is assessing a client with a suspected perforated peptic ulcer. Which of the following findings is most indicative of this condition?
- A. Sudden severe abdominal pain.
- B. Chronic epigastric pain.
- C. Soft, nontender abdomen.
- D. Frequent loose stools.
Correct Answer: A
Rationale: Sudden severe abdominal pain is a hallmark sign of a perforated peptic ulcer due to peritoneal irritation.
A client with a diagnosis of diabetes insipidus asks the nurse about the purpose of the vasopressin she has been prescribed. The nurse responds, knowing that this medication promotes which action?
- A. Vasodilation
- B. Decrease in peristalsis
- C. Decrease in urinary output
- D. Inhibit smooth muscle contraction
Correct Answer: C
Rationale: Vasopressin is a vasopressor and an antidiuretic. It directly stimulates contraction of smooth muscle, causes vasoconstriction, stimulates peristalsis, and increases reabsorption of water by the renal tubules, resulting in decreased urinary output.
A client with a history of liver cirrhosis is admitted with ascites. The nurse should monitor the client for which of the following complications?
- A. Hypotension.
- B. Respiratory distress.
- C. Hyperkalemia.
- D. Hypoglycemia.
Correct Answer: B
Rationale: Ascites can compress the diaphragm, leading to respiratory distress, a complication the nurse should monitor for in cirrhosis.