Nokea
A client with peripheral vascular disease and chronic obstructive pulmonary disease takes theophylline (Theo-Dur) 200 mg twice daily every day. The physician is considering adding pentoxifylline (Trental) to the regimen. The nurse should be aware that:
- A. The combination may increase the risk of bleeding
- B. The combination may increase theophylline levels
- C. The combination may cause severe hypotension
- D. The combination is contraindicated
Correct Answer: B
Rationale: Pentoxifylline may increase theophylline levels by inhibiting its metabolism, potentially leading to toxicity (e.g., nausea, tachycardia). The nurse should monitor theophylline levels and symptoms. Bleeding risk, severe hypotension, or contraindication are not documented interactions.
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A client with osteoporosis is prescribed alendronate (Fosamax). Which instruction should the nurse include?
- A. Take the medication at bedtime.
- B. Remain upright for 30 minutes after taking.
- C. Crush the tablet for easier swallowing.
- D. Take with a full meal.
Correct Answer: B
Rationale: Remaining upright for 30 minutes after taking alendronate prevents esophageal irritation.
The client with a major burn injury receives total parenteral nutrition (TPN). The expected outcome is to:
- A. Correct water and electrolyte imbalances.
- B. Allow the gastrointestinal tract to rest.
- C. Provide supplemental vitamins and minerals.
- D. Ensure adequate caloric and protein intake.
Correct Answer: D
Rationale: Major burn injuries significantly increase metabolic demands, requiring high caloric and protein intake to support healing and tissue repair. TPN is primarily used to meet these nutritional needs when oral or enteral feeding is not feasible.
At 8 a.m., the nurse reviews the amount of T-tube drainage for a client who underwent an open cholecystectomy yesterday. After reviewing the output record (see chart), the nurse should:
- A. Report the 24-hour drainage amount at 12. Clamp the T-tube.
- B. Evaluate the tube for patency.
- C. Irrigate the T-tube.
- D. Continue to monitor the drainage.
Correct Answer: C
Rationale: The T-tube should drain approximately 300 to 500 mL in the fi rst 24 hours and after 3 to 4 days the amount should decrease to less than 200 mL in 24 hours. With the sudden decrease in drainage at 8 a.m., the nurse should immediately assess the tube for obstruction of flow that can be caused by kinks in the tube or the client lying on the tube. Drainage color must also be assessed for signs of bleeding. The tube should not be irrigated or clamped without an order.
What is the priority nursing action for a client with a suspected brain tumor?
- A. Administer pain medication.
- B. Monitor neurological status.
- C. Provide emotional support.
- D. Restrict physical activity.
Correct Answer: B
Rationale: Monitoring neurological status is the priority to detect changes associated with a brain tumor.
What diet should be implemented for a client who is in the early stages of cirrhosis?
- A. High-calorie, high-carbohydrate.
- B. High-protein, low-fat.
- C. Low-fat, low-protein.
- D. High-carbohydrate, low-sodium.
Correct Answer: A
Rationale: A high-calorie, high-carbohydrate diet (A) supports energy needs in early cirrhosis. High-protein (B) may worsen encephalopathy. Low-fat, low-protein (C) is too restrictive. Low-sodium (D) is relevant for ascites, not early cirrhosis.