Nokea
A client with a history of gout is prescribed probenecid. The nurse should instruct the client to:
- A. Increase fluid intake.
- B. Avoid aspirin.
- C. Take the medication with meals.
- D. Stop the medication if pain resolves.
Correct Answer: A, B
Rationale: Increased fluid intake prevents kidney stones, and aspirin can reduce probenecid's effectiveness.
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A client was admitted to the surgical unit after right total knee arthroscopy performed 2 hours earlier. Which surgeon's prescription requires clarification?
- A. Maintain right knee in a slightly flexed position.
- B. Implement patient-controlled analgesia (PCA) per my protocol.
- C. Place sequential compression devices on both legs while on bed rest.
- D. Notify physical therapy to begin isometric quadriceps exercises on the day following surgery.
Correct Answer: A
Rationale: The knee is immobilized by a compression dressing to keep the knee in extension immediately after the operation. The nurse should clarify a prescription to keep the knee slightly flexed. Pain control by use of patient-controlled analgesia, use of compression devices to reduce the risk of thromboembolism, and physical therapy to begin isometric quadriceps exercises are expected prescriptions after total knee arthroscopy surgery.
A client is very dependent on the staff but is able to make simple decisions. The client asks, 'Would you do my laundry? I don't know how the machine works.' Which of the following responses would be best?
- A. Sure, I have time; I can do it for you.'
- B. You'll have to wait; I don't have time now.'
- C. Can your family do it for you?'
- D. Get your laundry; I'll show you how the machine works.'
Correct Answer: D
Rationale: Teaching the client to use the machine promotes independence while addressing their request.
A client with a history of atrial fibrillation is prescribed warfarin (Coumadin). The nurse should teach the client to avoid which of the following foods?
- A. Green leafy vegetables.
- B. Citrus fruits.
- C. Whole grains.
- D. Lean meats.
Correct Answer: A
Rationale: Green leafy vegetables are high in vitamin K, which can reduce warfarin's anticoagulant effect.
A client has just been diagnosed with right leg venous thromboembolism (VTE). Which interventions should the nurse implement? Select all that apply.
- A. Ice packs to the right leg
- B. Elevation of the right leg
- C. Hourly calf measurements
- D. Vigorous range of motion to the right leg
- E. Reposition the client carefully at regular intervals
Correct Answer: B,E
Rationale: Treatment for deep vein embolism (DVE) may require bed rest with repositioning of the client carefully at regular intervals, leg elevation, and application of warm moist heat to the affected leg. The client may have calf measurements prescribed once per shift or once per day, but they would not be obtained hourly. Option 1 is incorrect because heat, not cold, may be prescribed. Option 4 is dangerous to the client because vigorous activity after clot formation can cause pulmonary embolus.
When using crutches, the client should be instructed to bear weight primarily on the:
- A. Axillae
- B. Elbows
- C. Upper arms
- D. Hands
Correct Answer: D
Rationale: Weight should be borne on the hands when using crutches to prevent nerve damage from pressure on the axillae. Elbows and upper arms are not primary weight-bearing areas.