Nokea
A client with asthma develops respiratory acidosis. Based on this diagnosis, what should the nurse expect the client's serum potassium level to be?
- A. normal
- B. elevated
- C. low
- D. unrelated to the pH
Correct Answer: B
Rationale: Hyperkalemia occurs in a state of acidosis because potassium moves from injured cells into the bloodstream.
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The nurse is discharging the child with sickle cell disease who has undergone a splenectomy. The child has an allergy to penicillin. The nurse should anticipate teaching about which prophylactic medication?
- A. Epoetin
- B. Amoxicillin
- C. Morphine sulfate
- D. Erythromycin ethylsuccinate
Correct Answer: D
Rationale: A: Epoetin (Epogen) stimulates the bone marrow to produce RBCs. In sickle cell disease, increasing the production of sickled RBCs can worsen the condition. B: Amoxicillin (Amoxil) is contraindicated when allergies to penicillin are present. C: Opioids such as morphine sulfate are administered in sickle cell crises or for severe pain; it is usually not given prophylactically. D: The ability to fight infection is decreased following a splenectomy. Daily prophylactic antibiotics are given. Erythromycin ethylsuccinate (E.E.S.) is a macrolide antibiotic and safe to administer when a penicillin allergy exists.
The parent of the 2-year-old with asthma has been given instructions about asthma control and Step Therapy. Which statement, if made by the parent, should indicate to the nurse that the parent has an adequate understanding of the instructions?
- A. If my child has wheezing twice a week or less, I should add the nebulized corticosteroid and make an appointment.
- B. If my child has a respiratory tract infection I should add the nebulized corticosteroid and make an appointment.
- C. If my child has to use the nebulizer less than twice a week, I should add the nebulized corticosteroid and make an appointment.
- D. If my child has nighttime awakenings with wheezing twice a month or more, I should add the nebulized corticosteroid and make an appointment.
Correct Answer: D
Rationale: A: Asthma symptoms (wheezing) occurring 2 or fewer days per week should be treated at Step 1. B: A respiratory tract infection may require the increased use of short-acting beta agonists, but an inhaled corticosteroid should not be added until the child is evaluated by the HCP. C: The use of the nebulizer twice a week or less should be treated at Step 1. D: Nighttime waking with asthma symptoms 1 to 2 times per month indicates the need to proceed to Step 2 therapy, which includes the use of an inhaled corticosteroid.
The major electrolytes in the extracellular fluid are:
- A. potassium and chloride.
- B. potassium and phosphate.
- C. sodium and chloride.
- D. sodium and phosphate.
Correct Answer: C
Rationale: Sodium and chloride are the major electrolytes in the extracellular fluid.
The client has a new prescription for metoclopramide. The nurse notifies the HCP because the client has a contraindication for metoclopramide use. Which information in the client's medical record most likely prompted the nurse's notification of the HCP?
- A. Use of nasogastric suctioning
- B. History of diabetes mellitus
- C. History of seizure disorders
- D. Chemotherapy treatment for cancer
Correct Answer: C
Rationale: A: The use of NG suctioning alone would not prevent metoclopramide use. Metoclopramide can be administered through the NG tube; the tube is then clamped for an hour after administration until absorption occurs. B: Metoclopramide should be used with caution with DM, but it is not contraindicated. C: The client's history of a seizure disorder would contraindicate the use of metoclopramide. Because metoclopramide (Reglan) blocks dopamine receptors in the chemoreceptor trigger zone of the CNS, it is contraindicated in seizure disorders. D: Metoclopramide is used in the treatment of nausea and vomiting for clients receiving chemotherapy.
The nurse is storing vaccines for future use. What should the nurse do so they are properly stored? Select all that apply.
- A. Place all vaccines in a temperature-controlled refrigerator.
- B. Complete periodic checks of the expiration date on the vaccines.
- C. Place bulk supplies of vaccines in a temperature-controlled freezer.
- D. Avoid storing vaccines on the shelf in the door of the refrigerator.
- E. Do not store food or beverage in the same refrigerator or freezer as the vaccines.
Correct Answer: B,D,E,F
Rationale: A: Not all vaccines are refrigerated; some vaccines will be inactivated by refrigeration and freezing. B: Periodic checking for expiration dates is necessary to ensure that outdated vaccines are not administered. C: Not all bulk supplies should be placed in a freezer; some vaccines are inactivated by freezing. D: When refrigeration is required, a main shelf inside the refrigerator is best because a shelf in the door will have frequent temperature changes that will alter the potency of the vaccine. E: Storing food and beverage in the same unit may result in frequent opening of the unit, leading to greater chance of temperature instability and light exposure. Contamination may also result. F: Aluminum foil or packaging can be used to protect light-sensitive vaccines.