Nokea
A client with a history of heart failure is prescribed valsartan (Diovan). The nurse should monitor the client for which of the following side effects?
- A. Hyperkalemia.
- B. Hypoglycemia.
- C. Weight gain.
- D. Hypertension.
Correct Answer: A
Rationale: Valsartan, an ARB, can cause hyperkalemia, requiring monitoring of potassium levels.
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A client is a 43-year-old G2 P1 at 16 weeks' gestation that has completed prenatal testing for chromosomal abnormalities. The results reveal the infant is a female with Down syndrome. The nurse should tell the parents which of the following? Check all that apply.
- A. Down syndrome can occur in mothers of any age.
- B. Down syndrome is correlated with autosomal dominant traits carried by the parents.
- C. Down syndrome is a result of autosomal recessive traits carried by the parents.
- D. Down syndrome depends upon maternal prenatal care since pregnancy began.
- E. Down syndrome occurs more frequently with advanced maternal age.
- F. Down syndrome results from a trisomy of chromosome 21.
Correct Answer: A,E,F
Rationale: Down syndrome can occur at any maternal age, is more frequent with advanced maternal age, and results from trisomy 21. It is not related to dominant/recessive traits or prenatal care.
The nurse is monitoring a client who has received antidysrhythmic therapy for the treatment of premature ventricular contractions (PVCs). Which observation in the PVCs would indicate to the nurse that this therapy is ineffective?
- A. Occur in pairs
- B. Be unifocal in appearance
- C. Be fewer than 6 per minute
- D. Fall after the end of the T wave
Correct Answer: A
Rationale: PVCs are considered dangerous when they are frequent (more than 6 per minute), occur in pairs or couplets, are multifocal (multiform), or fall on the T wave.
A woman is taking oral contraceptives. The nurse teaches the client that medications that may interfere with oral contraceptive efficacy include:
- A. Antihypertensives.
- B. Antibiotics.
- C. Diuretics.
- D. Antihistamines.
Correct Answer: B
Rationale: Certain antibiotics (e.g., rifampin) can reduce oral contraceptive efficacy by altering gut flora, affecting hormone absorption.
A male client has been diagnosed as having a low sperm count during infertility studies. After instructions by the nurse about some causes of low sperm counts, the nurse determines that the client needs further instructions when he says low sperm counts may be caused by which of the following?
- A. Varicocele.
- B. Frequent use of saunas.
- C. Endocrine imbalances.
- D. Decreased body temperature.
Correct Answer: D
Rationale: Decreased body temperature is not a cause of low sperm count; elevated temperatures, such as from saunas, can impair spermatogenesis, indicating a need for further teaching.
You are caring for a multiple trauma client who has just arrived at the emergency room with a number of other external disaster victims. This client has multiple blast injuries and hypovolemic shock; it is anticipated that this unstable critically injured and unconscious client will have long term intravenous therapy, blood products and possibly hyperalimentation as well. Which type of venous access would you most likely anticipate for this client?
- A. A percutaneous, non tunneled subclavian catheter
- B. A peripheral intravenous catheter that is 20 gauge
- C. A multi lumen implanted tunneled and cuffed central venous catheter
- D. A peripherally inserted central venous catheter
Correct Answer: C
Rationale: A multi-lumen tunneled and cuffed central venous catheter is ideal for long-term therapy due to its durability and lower infection risk.