Nokea
A client with coronary artery disease is being seen in the clinic for a follow-up examination. During medication reconciliation, the nurse identifies which reported medication as requiring further investigation?
- A. 10 mg isosorbide dinitrate twice daily
- B. 20 mg atorvastatin once daily
- C. 500 mg naproxen twice daily
- D. 2,000 mg fish oil once daily
Correct Answer: C
Rationale: Naproxen (C), an NSAID, increases cardiovascular risk and bleeding, requiring investigation in coronary artery disease. Isosorbide (A), atorvastatin (B), and fish oil (D) are appropriate.
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The nurse is caring for a 12 year-old with an acute illness. Which of the following indicates the nurse understands common sibling reactions to hospitalization?
- A. Younger siblings adapt very well
- B. Visitation is helpful for both
- C. The siblings may enjoy privacy
- D. Those cared for at home cope better
Correct Answer: B
Rationale: Visitation is helpful for both. Contact with the ill child helps siblings understand hospitalization and maintain relationships.
Which of the following organs is most likely to suffer permanent damage from shock?
- A. The heart
- B. The skin
- C. The brain
- D. The kidneys
Correct Answer: D
Rationale: The kidneys are highly susceptible to permanent damage from shock due to reduced perfusion, leading to acute kidney injury.
The nurse is caring for a client with increased intracranial pressure (ICP). Which statement by the unlicensed assistive personnel would require immediate intervention by the nurse?
- A. I will raise the head of the bed so it is easier to see the television.
- B. I will turn down the lights when I leave.
- C. Let me move your belongings closer so you can reach them
- D. You should do deep breathing and coughing exercises.
Correct Answer: A
Rationale: Raising the head of the bed (A) without medical guidance can alter ICP dangerously. Dimming lights (B), moving belongings (C), and breathing exercises (D) are generally safe or neutral.
The day shift nurse provides handoff of care report to the oncoming night shift nurse. Which of the following statements by the nurse are appropriate to include in the report? Select all that apply.
- A. I gave acetaminophen 500 mg PO to the client for a headache, with good relief.
- B. The client had morphine 15 mg PO 45 minutes ago for leg pain and now reports 3 on a pain scale of 0-10.
- C. The client's sisters visited today and were very rude, but they did bring the client's medication list.
- D. The continuous bladder irrigation normal saline infusion bag will need to be replaced at 9 PM.
- E. The radiology department called to say that an ultrasound will be performed at 9 PM.
Correct Answer: A,B,D,E
Rationale: Acetaminophen administration (A), morphine effect (B), irrigation replacement (D), and ultrasound schedule (E) are relevant to care. Family behavior (C) is subjective and inappropriate.
Which nursing diagnosis is most appropriate for a client who has Cushing's syndrome?
- A. Risk for injury related to osteoporosis
- B. Pain related to cold intolerance
- C. Risk for deficient fluid volume related to excessive loss of sodium and water secondary to polyuria
- D. Risk for injury related to postural hypotension
Correct Answer: A
Rationale: Cushing's syndrome causes cortisol excess, leading to osteoporosis and increased fracture risk, making 'Risk for injury related to osteoporosis' the most appropriate diagnosis.