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A client with a urinary tract infection (UTI) is prescribed antibiotics. What is the most important instruction for the nurse to give the client?
- A. Take the antibiotics with food
- B. Complete the full course of antibiotics
- C. Increase fluid intake to at least 2 liters per day
- D. Take over-the-counter pain relievers for discomfort
Correct Answer: B
Rationale: The most crucial instruction for the nurse to give a client with a UTI who is prescribed antibiotics is to complete the full course of antibiotics. Completing the full course of antibiotics is essential to ensure that the infection is fully treated and to prevent the development of antibiotic resistance. While taking antibiotics with food, increasing fluid intake, and managing discomfort with pain relievers are important aspects of UTI management, completing the prescribed course of antibiotics is the top priority to achieve the best treatment outcomes and prevent recurrence of the infection.
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A client with chronic liver disease develops jaundice. What is the most important assessment the nurse should perform?
- A. Assess the client's skin for lesions or sores.
- B. Monitor the client's liver function tests.
- C. Assess for changes in mental status and behavior.
- D. Monitor the client's urine output closely.
Correct Answer: D
Rationale: In a client with chronic liver disease developing jaundice, the most important assessment the nurse should perform is to monitor the client's urine output closely. Jaundice can indicate worsening liver function, so monitoring urine output helps assess kidney function and fluid balance, which are critical in chronic liver disease. Assessing the client's skin for lesions or sores (Choice A) may be relevant for dermatological conditions but is not the priority in this case. Monitoring liver function tests (Choice B) is important but may not provide immediate information on the client's current status. Assessing for changes in mental status and behavior (Choice C) is important for detecting hepatic encephalopathy but does not directly address the immediate concern of fluid balance and kidney function in the presence of jaundice.
A client is admitted with an epidural hematoma after a skateboarding accident. How should the nurse differentiate the vascular source of intracranial bleeding?
- A. Monitor for clear fluid leakage from the nose.
- B. Assess for rapid onset of decreased level of consciousness.
- C. Check for bruising around the head and neck.
- D. Assess for changes in pupil size and reactivity.
Correct Answer: B
Rationale: An epidural hematoma is characterized by a rapid onset of symptoms, including decreased level of consciousness, due to arterial bleeding, which differentiates it from other types of intracranial hemorrhage. Monitoring for clear fluid leakage from the nose (choice A) is more indicative of a basilar skull fracture and cerebrospinal fluid leak. Checking for bruising around the head and neck (choice C) is more suggestive of soft tissue injuries or facial fractures. Assessing for changes in pupil size and reactivity (choice D) is essential in evaluating traumatic brain injuries, but it is not specific to differentiating the vascular source of intracranial bleeding in an epidural hematoma.
A client with diabetes mellitus presents with a blood sugar level of 320 mg/dL. What is the nurse's initial action?
- A. Administer sliding scale insulin as prescribed
- B. Encourage the client to drink fluids
- C. Provide the client with a carbohydrate snack
- D. Assess the client for signs of hypoglycemia
Correct Answer: A
Rationale: When a client with diabetes mellitus presents with a high blood sugar level of 320 mg/dL, the nurse's initial action should be to administer sliding scale insulin as prescribed. The priority is to bring down the elevated glucose level promptly to prevent further complications. Encouraging the client to drink fluids or providing a carbohydrate snack would not effectively address the elevated blood sugar level in this scenario. Assessing for signs of hypoglycemia is not appropriate as the client's blood sugar level is high, not low.
The nurse is preparing to administer an intramuscular injection to an adult client. Which site should the nurse select?
- A. Deltoid muscle
- B. Ventrogluteal muscle
- C. Vastus lateralis muscle
- D. Dorsogluteal muscle
Correct Answer: B
Rationale: The ventrogluteal site is preferred for intramuscular injections in adults because it is free from major blood vessels and nerves, reducing the risk of injury. The deltoid muscle can be used for smaller volumes of medication, primarily vaccines. The vastus lateralis muscle is commonly used in infants, toddlers, and young children. The dorsogluteal muscle site is discouraged due to its proximity to the sciatic nerve, increasing the risk of injury or nerve damage.
A client with tuberculosis (TB) is being discharged on isoniazid and rifampin. What instruction should the nurse prioritize?
- A. Complete the full course of antibiotics.
- B. Notify the healthcare provider if you experience tingling in your fingers.
- C. Use a disposable mask when in contact with others.
- D. Monitor liver function tests monthly.
Correct Answer: C
Rationale: The correct answer is to instruct the client to use a disposable mask when in contact with others. TB is highly contagious, and wearing a mask can help prevent the spread of the disease to others. Choice A is important but not the priority as using a mask directly impacts public health. Choice B is related to a potential side effect of isoniazid, peripheral neuropathy, but immediate healthcare provider notification is not required. Choice D is relevant due to the potential hepatotoxicity of isoniazid and rifampin, but it is not the priority instruction in this scenario.