Nokea
A client with a history of migraines is prescribed sumatriptan (Imitrex). The nurse should instruct the client to take the medication:
- A. Daily to prevent migraines.
- B. At the onset of a migraine.
- C. With meals to enhance absorption.
- D. At bedtime to reduce side effects.
Correct Answer: B
Rationale: Sumatriptan is most effective when taken at the onset of a migraine to abort the headache.
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A client is admitted to the hospital with a diagnosis of infiltrating ductal carcinoma of the breast. Which expected manifestation should the nurse assess the client for?
- A. Bilateral palpable masses
- B. Pain in the breast and edema
- C. A fixed, irregularly shaped mass
- D. A round-shaped mass that is moveable
Correct Answer: C
Rationale: Infiltrating ductal carcinoma of the breast usually presents as a fixed, irregularly shaped mass. The mass is usually single and unilateral and is painless, nontender, and hard to the touch.
The nurse provides discharge instructions to a client after implantation of a permanent pacemaker. The nurse should instruct the client to avoid exposure to which item?
- A. Hair dryers
- B. Electric blankets
- C. Electric toothbrushes
- D. Airport metal detectors
Correct Answer: D
Rationale: A pacemaker is shielded from interference from most electrical devices. Devices to be forewarned about include those with a strong electric current or magnetic field, such as antitheft devices in stores, metal detectors used in airports, and radiation therapy (if applicable and which might require relocation of the pacemaker). Radios, televisions, electric blankets, toasters, microwave ovens, heating pads, and hair dryers are considered to be safe.
A client is scheduled to have surgery. The nurse should place priority on determining whether the surgeon wants which medications held in the preoperative period to assure client safety?
- A. Warfarin
- B. Furosemide
- C. Famotidine
- D. Multivitamin with minerals
Correct Answer: A
Rationale: The nurse is careful to question the surgeon about whether warfarin should be administered in the preoperative period. This medication is often withheld for a period of time preoperatively to minimize the risk of hemorrhage during surgery. The other medications may also be withheld if specifically prescribed, but usually they are discontinued as part of an NPO (nothing by mouth) after midnight prescription.
When performing an assessment on a mother who just delivered a healthy newborn, the nurse should expect to note that the fundus is positioned at which location?
- A. To the right of the abdomen
- B. At the level of the umbilicus
- C. Above the level of the umbilicus
- D. One fingerbreadth above the symphysis pubis
Correct Answer: B
Rationale: Immediately after delivery, the uterine fundus should be at the level of the umbilicus or one to three fingerbreadths below it and in the midline of the abdomen. A fundus that is not located in the midline may indicate a full bladder. If the fundus is above the umbilicus, this may indicate that blood clots in the uterus need to be expelled by fundal massage.
Select the sound that is heard with percussion with its description.
- A. Tympany: A hollow sound
- B. Dullness: A thud like sound
- C. Dullness: A hollow sound
- D. Resonance: A booming sound
Correct Answer: A,B,D
Rationale: Tympany is a hollow sound (e.g., over air-filled structures like the stomach), dullness is a thud-like sound (e.g., over solid organs like the liver), and resonance is a booming sound (e.g., over lung tissue). Option C is incorrect because dullness is not a hollow sound.