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A client with a history of peptic ulcer disease is admitted with severe abdominal pain. Which medication would the nurse expect to administer?
- A. Ibuprofen (Advil)
- B. Omeprazole (Prilosec)
- C. Aspirin
- D. Acetaminophen (Tylenol)
Correct Answer: B
Rationale: Omeprazole, a proton pump inhibitor, reduces acid production, aiding ulcer healing. Ibuprofen (A) and aspirin (C) worsen ulcers, and acetaminophen (D) addresses pain but not acid.
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The nurse is assessing the client’s bowel sounds. Which finding indicates normal bowel sounds?
- A. Stronger than normal
- B. Hypoactive
- C. Normal
- D. Hyperactive
Correct Answer: C
Rationale: Normal bowel sounds are described as 'normal,' occurring every 5–20 seconds with a gurgling quality. Stronger than normal or hyperactive sounds suggest increased motility (e.g., diarrhea), while hypoactive sounds indicate reduced motility (e.g., ileus).
The nurse is preparing to administer a dose of ondansetron (Zofran) for nausea. Which route is most appropriate for rapid onset?
- A. Oral
- B. Intramuscular
- C. Intravenous
- D. Sublingual
Correct Answer: C
Rationale: Intravenous ondansetron provides the fastest onset for nausea relief, ideal in acute settings. Oral and sublingual routes are slower, and IM is less common.
An 18-year-old girl is admitted to the hospital with a depressed skull fracture as a result of a car accident. If the nurse were to observe a rising pulse rate and lowering blood pressure, the nurse would suspect that the client:
- A. Has a sudden and severe increase in intracranial pressure
- B. Has sustained an internal injury in addition to the head injury
- C. Is beginning to experience a dangerously high level of anxiety
- D. Is having intracranial bleeding
Correct Answer: B
Rationale: Rising pulse rate and lowering blood pressure are indicative of hypovolemia, which is consistent with an internal injury causing blood loss.
The client is receiving total parenteral nutrition (TPN). Which assessment finding requires immediate action?
- A. Blood glucose of 200 mg/dL
- B. Weight gain of 1 pound in 24 hours
- C. Temperature of 99.8°F
- D. Dry, cracked lips
Correct Answer: A
Rationale: A blood glucose of 200 mg/dL indicates hyperglycemia, a common TPN complication requiring immediate action to adjust infusion or administer insulin. Weight gain, low-grade fever, and dry lips are less urgent.
A client with a history of liver failure is admitted with complaints of confusion. The nurse should expect the client to have:
- A. Hyperammonemia
- B. Hypoglycemia
- C. Hypercalcemia
- D. Hypokalemia
Correct Answer: A
Rationale: Liver failure impairs ammonia detoxification, leading to hyperammonemia, which causes hepatic encephalopathy and confusion.