A client with bipolar disorder is discharged with a prescription for Depakote (divalproex sodium). The nurse should remind the client of the need for:
- A. Frequent dental visits
- B. Frequent lab work
- C. Additional fluids
- D. Additional sodium
Correct Answer: B
Rationale: Depakote requires regular lab monitoring (e.g., liver function, platelet counts) to detect potential side effects like hepatotoxicity or thrombocytopenia.
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The nursing team includes two RNs, one LPN/LVN, and one nursing assistant. The nurse should consider the assignments appropriate if the nursing assistant is assigned to care for
- A. a client with Alzheimer’s requiring assistance with feeding.
- B. a client with osteoporosis complaining of burning on urination.
- C. a client with scleroderma receiving a tube feeding.
- D. a client with cancer who has Cheyne-Stokes respirations.
Correct Answer: A
Rationale: standard, unchanging procedure
A client with adult respiratory distress syndrome has been placed on mechanical ventilation with PEEP. Which finding would indicate to the nurse that the client is experiencing the undesirable effect of an increase in airway and chest pressure?
- A. A PO2 of 88
- B. Rales on auscultation
- C. Blood pressure decrease to 90/48 from 120/70
- D. A decrease in spontaneous respirations
Correct Answer: C
Rationale: PEEP can increase intrathoracic pressure, reducing venous return and causing hypotension (e.g., BP drop to 90/48), an undesirable effect requiring intervention.
Which activity is best suited to the 12-year-old with juvenile rheumatoid arthritis?
- A. Playing video games
- B. Swimming
- C. Working crossword puzzles
- D. Playing slow-pitch softball
Correct Answer: B
Rationale: Swimming is low-impact, promoting joint mobility and muscle strength without stressing joints in juvenile rheumatoid arthritis.
Four clients are admitted to a medical unit. If only one private room is available, it should be assigned to:
- A. The client with ulcerative colitis
- B. The client with neutropenia
- C. The client with cholecystitis
- D. The client with polycythemia vera
Correct Answer: B
Rationale: Neutropenia increases infection risk, so a private room minimizes exposure to pathogens.
The nurse is working in the emergency room when a client arrives with severe burns of the left arm, hands, face, and neck. Which action should receive priority?
- A. Starting an IV
- B. Applying oxygen
- C. Obtaining blood gases
- D. Medicating the client for pain
Correct Answer: B
Rationale: Applying oxygen is the priority to ensure airway patency and oxygenation in a client with facial and neck burns, which can cause airway compromise.
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