Nokea
A client with a history of stroke is prescribed clopidogrel (Plavix). The nurse should instruct the client to report which of the following side effects immediately?
- A. Mild headache.
- B. Bruising.
- C. Nausea.
- D. Fatigue.
Correct Answer: B
Rationale: Bruising may indicate bleeding, a serious side effect of clopidogrel, an antiplatelet medication, requiring immediate reporting.
You may also like to solve these questions
The nurse developing a plan of care for a postterm small-for-gestational-age (SGA) newborn should identify which assessment as the priority to monitor?
- A. Urinary output
- B. Blood glucose levels
- C. Total bilirubin levels
- D. Hemoglobin and hematocrit
Correct Answer: B
Rationale: The most common metabolic complication in the SGA newborn is hypoglycemia, which can produce central nervous system abnormalities and mental retardation if not corrected immediately. Urinary output, although important, is not the highest priority action; however, the postterm SGA newborn is typically dehydrated from placental dysfunction. Hemoglobin and hematocrit levels are monitored because the postterm SGA newborn exhibits polycythemia, although this also does not require immediate attention. The polycythemia contributes to increased bilirubin levels, usually beginning on the second day after delivery.
Which of these is a form of therapeutic communication?
- A. Probing for more information from the client
- B. Sublimation to determine hidden messages
- C. Providing privacy so the client is comfortable
- D. Silence to allow contemplation and thought
Correct Answer: D
Rationale: Silence is a therapeutic communication technique that allows the client time to process thoughts and emotions, fostering reflection.
A client diagnosed with active tuberculosis (TB) is to be admitted to a medical-surgical unit. Which action should the nurse take when planning a bed assignment?
- A. Place the client in a private, well-ventilated room.
- B. Plan to transfer the client to the intensive care unit.
- C. Reserve the bed furthest away from the door in a double room.
- D. Assign the client to share a double room with a noninfectious client.
Correct Answer: A
Rationale: According to category-specific (respiratory) isolation precautions, a client with TB requires a private room. The room needs to be well ventilated and should have at least 6 to 12 exchanges of fresh air per hour and should be ventilated to the outside if possible. Therefore, option 1 is the only correct choice.
A client with diabetes is explaining to the nurse how she will care for her feet at home. Which statement indicates that the client understands proper foot care?
- A. When I injure my toe, I will plan to put iodine on it.'
- B. I should inspect my feet at least once a week.'
- C. It is okay to go barefoot in the house.'
- D. It is important to dry my feet carefully after my bath.'
Correct Answer: D
Rationale: Thorough drying prevents moisture-related infections, critical for diabetic foot care to avoid complications like ulcers.
The nurse is reviewing the laboratory results of a client with hypothyroidism. An expected finding is:
- A. Decreased thyroxine (T4) and increased thyroid-stimulating hormone (TSH) levels
- B. Decreased TSH and increased T4 levels
- C. Decreased creatine phosphokinase levels
- D. Absence of antithyroid antibodies
Correct Answer: A
Rationale: Hypothyroidism is characterized by decreased thyroxine (T4) and increased TSH as the pituitary attempts to stimulate the thyroid. Other options are inconsistent with hypothyroidism.