Nokea
A client with bladder cancer receives intravesical chemotherapy. The nurse should:
- A. Monitor for hematuria.
- B. Restrict fluids.
- C. Administer pain medication.
- D. Encourage bed rest.
Correct Answer: A
Rationale: Hematuria is a potential side effect of intravesical chemotherapy, requiring monitoring.
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The nurse is to administer flumazenil (Mazicon) I.V. for reversal of sedation. Which of the following interventions should be included in the care plan? Select all that apply.
- A. Administer the medication as a 2-mg bolus.
- B. Give the medication undiluted in incremental doses.
- C. Be alert for shivering and hypotension.
- D. Use only a free-flowing I.V. line in a large vein.
- E. Monitor the client's level of consciousness.
Correct Answer: B,C,D,E
Rationale: Flumazenil is given undiluted in incremental doses (B), via a free-flowing IV line (D), with monitoring for side effects like shivering and hypotension (C) and level of consciousness (E). A 2-mg bolus (A) is incorrect, as flumazenil is titrated in smaller doses.
The nurse is developing a program on skin cancer prevention for a community group. Which of the following should be included in the program? Select all that apply.
- A. Purchase sunscreen containing benzophenoness to check UVA and UVB rays.
- B. Use sunscreen with a minimum of 15 sun protection factor (SPF).
- C. Obtain genetic screening to identify risk of melanoma.
- D. Apply sunscreen only on sunny days, especially between 10 AM and 2 PM.
- E. Have a pigmented lesion biopsied by shaving if it looks suspicious.
- F. Rub baby oil to lubricate skin before going out in the sun.
Correct Answer: A,B
Rationale: Sunscreen with benzophenones and SPF 15 or higher protects against UVA/UVB rays. Genetic screening is not routine, sunscreen should be used daily, shave biopsies are inappropriate, and baby oil increases UV damage.
Metoclopramide (Reglan) is ordered as a premedication for a client about to undergo a gastroduodenoscopy. The nurse expects which of the following as the primary therapeutic effect?
- A. Increased gastric pH.
- B. Increased gastric emptying.
- C. Reduced anxiety.
- D. Inhibited respiratory secretions.
Correct Answer: B
Rationale: Metoclopramide promotes gastric emptying, which is beneficial before gastroduodenoscopy to reduce the risk of aspiration and improve visualization.
The nurse is reviewing laboratory reports for a client who is taking allopurinol (Zyloprim). Which of the following indicate that the drug has had a therapeutic effect?
- A. Decreased urine alkaline phosphatase level.
- B. Increased urine calcium excretion.
- C. Increased serum calcium level.
- D. Decreased serum uric acid level.
Correct Answer: D
Rationale: Allopurinol reduces serum uric acid levels, indicating therapeutic effectiveness in preventing uric acid stone formation.
A client is being treated for deep vein thrombosis (DVT) in the left femoral artery. The physician has ordered 60 mg of enoxaparin (Lovenox) subcutaneously. Before administering the drug, the nurse checks the client's laboratory results, noted below. Based on these results, the nurse should:
- A. Assess the client for bleeding
- B. Administer the medication
- C. Inform the physician
- D. Withhold the dose of Lovenox
Correct Answer: C
Rationale: Without specific lab results provided, the context implies abnormal values (e.g., low platelets or high INR) that increase bleeding risk with enoxaparin, a low-molecular-weight heparin. The nurse should inform the physician to evaluate the results before proceeding. Administering or withholding without consultation is unsafe, and assessing for bleeding is not the immediate action.