Nokea
A client with glaucoma has been prescribed Timoptic (timolol) eye drops. Timoptic should be used with caution in the client with a history of:
- A. Diabetes
- B. Gastric ulcers
- C. Emphysema
- D. Pancreatitis
Correct Answer: C
Rationale: Timolol, a beta-blocker, can exacerbate emphysema by causing bronchoconstriction. Diabetes , ulcers , and pancreatitis are not contraindications.
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A 57 year-old male client has a hemoglobin of 10 mg/dl and a hematocrit of 32%. What would be the most appropriate follow-up by the home care nurse?
- A. Ask the client if he has noticed any bleeding or dark stools
- B. Tell the client to call 911 and go to the emergency department immediately
- C. Schedule a repeat Hemoglobin and Hematocrit in 1 month
- D. Tell the client to schedule an appointment with a hematologist
Correct Answer: A
Rationale: Ask the client if he has noticed any bleeding or dark stools. These values indicate mild anemia, and the first step is to assess for potential sources of blood loss.
A client with tuberculosis has an order for Rifadin (rifampin). What vitamin is usually given with rifampin?
- A. Thiamine
- B. Pyridoxine
- C. Folic acid
- D. Cyanocobalamin
Correct Answer: B
Rationale: Pyridoxine (vitamin B6) is given with rifampin to prevent peripheral neuropathy, a side effect. Other vitamins are not typically associated with rifampin therapy.
A client diagnosed with trigeminal neuralgia is given a prescription of carbamazepine by the health care provider. Which intervention does the nurse anticipate in this client's care plan?
- A. Encourage client to drink cold beverages
- B. Encourage client to eat a high-fiber diet
- C. Encourage client to perform facial massage
- D. Encourage client to report any fever or sore throat
Correct Answer: D
Rationale: Carbamazepine can cause agranulocytosis or infections; fever or sore throat must be reported. Cold beverages may trigger trigeminal neuralgia pain. High-fiber diets and facial massage are unrelated to management.
The nurse is caring for a client who had a total thyroidectomy. What should the nurse plan to observe the client for immediately after his return to the nursing care unit?
- A. Hoarseness
- B. Signs of hypercalcemia
- C. Loss of reflexes
- D. Mental confusion
Correct Answer: B
Rationale: Total thyroidectomy risks parathyroid gland damage, leading to hypocalcemia (not hypercalcemia). However, the question likely intends hypocalcemia signs (tetany, spasms), which are critical to monitor immediately post-surgery. Hoarseness, reflexes, or confusion are less urgent.
Which findings reflect vital signs that are concerning and require further nursing monitoring and intervention? Select all that apply.
- A. After albuterol administration, 5-year-old client has a pulse of 120/min and reports tremor
- B. After hydromorphone 1 mg IV push, blood pressure decreases from 130/80 mm Hg to 110/70 mm Hg
- C. Blood pressure is 90/60 mm Hg, and the nurse is preparing to administer prescribed nifedipine
- D. Blood pressure was 120/80 mm Hg and pulse was 80/min before blood transfusion, current values are 90/70 mm Hg and 100/min, respectively
- E. Fetal heart rate monitored during labor decreases from 140/min to 100/min following a contraction
Correct Answer: C,D,E
Rationale: Hypotension (90/60 mm Hg) with nifedipine risks severe hypotension. Transfusion-related hypotension and tachycardia suggest a reaction. Fetal heart rate deceleration post-contraction indicates potential distress. Albuterol's tachycardia/tremor and hydromorphone's mild BP drop are expected.