Nokea
A client with cancer is to undergo an intravenous pyelogram. The nurse should:
- A. Force fluids 24 hours before the procedure
- B. Ask the client to void immediately before the study
- C. Hold medication that affects the central nervous system for 12 hours pre- and post-test
- D. Cover the client's reproductive organs with an x-ray shield.
Correct Answer: B
Rationale: Voiding immediately before an IVP ensures the bladder is empty, improving visualization of the urinary tract.
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The nurse notes the patient care assistant looking through the personal items of the client with cancer. Which action should be taken by the registered nurse?
- A. Notify the police department as a robbery
- B. Report this behavior to the charge nurse
- C. Monitor the situation and note whether any items are missing
- D. Ignore the situation until items are reported missing
Correct Answer: B
Rationale: Reporting to the charge nurse ensures proper investigation.
A client with schizophrenia is receiving depot injections of Haldol Deconate (haloperidol decanoate). The client should be told to return for his next injection in:
- A. 1 week
- B. 2 weeks
- C. 4 weeks
- D. 6 weeks
Correct Answer: C
Rationale: Haldol Decanoate is a long-acting depot injection typically administered every 4 weeks for maintenance therapy in schizophrenia.
A client has a chest tube in place with a three-chamber chest drainage system. The nurse notes continuous bubbling in the water seal chamber. This indicates which of the following?
- A. Pneumothorax.
- B. Suction is adequate.
- C. System air leak.
- D. The tube is positioned incorrectly.
Correct Answer: C
Rationale: Continuous bubbling in the water seal chamber indicates a system air leak (C), such as a loose connection or hole in the tubing. A pneumothorax (A) may cause intermittent bubbling, adequate suction (B) is indicated by bubbling in the suction chamber, and incorrect tube positioning (D) would not typically cause continuous bubbling.
The nurse is caring for a client who is 12 weeks pregnant and presented with the following symptoms: mild uterine cramping with spotting of blood. The cervical os is closed upon examination. How should the nurse chart the findings?
- A. missed miscarriage
- B. complete miscarriage
- C. inevitable miscarriage
- D. threatened miscarriage
Correct Answer: D
Rationale: Mild cramping, spotting, and a closed cervical os at 12 weeks indicate a threatened miscarriage, where the pregnancy may still continue.
The nurse has an order to give 500 mL of 0.45% NS over 12 hours. The IV set has a drop factor of 10. How many gtts/min should the client receive? Fill in the blank.
Correct Answer: 7
Rationale: Rate = 500 mL ÷ 12 hr = 41.67 mL/hr. Drops/min = (41.67 mL/hr × 10 gtts/mL) ÷ 60 min = 6.94 gtts/min, rounded to 7 gtts/min.