Nokea
A client with renal calculi is prescribed tamsulosin. The nurse explains it:
- A. Dissolves stones.
- B. Relaxes ureter muscles.
- C. Reduces urine output.
- D. Prevents infection.
Correct Answer: B
Rationale: Tamsulosin relaxes ureter muscles, aiding stone passage.
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A client with aortic stenosis complains of increasing dyspnea and dizziness. Identify the area where the nurse would place the stethoscope to assess a murmur from aortic stenosis.
- A. 1
- B. 2
- C. 3
- D. 4
- E. 5
Correct Answer: A
Rationale: The stethoscope is placed at the second intercostal space right of sternum (1) to assess the aortic area. (2) is the pulmonic valve area, (3) is Erb’s point, (4) is the Tricuspid valve area, and (5) is the Mitral valve area.
A client is admitted for a revascularization procedure for arteriosclerosis in his left iliac artery. To promote circulation in the extremities, the nurse should:
- A. Position the client on a firm mattress
- B. Keep the involved extremity warm with blankets
- C. Position the left leg at or below the body's horizontal plane
- D. Encourage the client to raise and lower his leg four times every hour
Correct Answer: C
Rationale: Positioning the left leg at or below the body's horizontal plane promotes arterial blood flow to the extremity in arteriosclerosis, avoiding gravitational resistance. A firm mattress is irrelevant, warmth is beneficial but secondary, and leg raises may not be feasible pre-revascularization.
The nurse is to administer subcutaneous heparin to an older adult. What facts should the nurse keep in mind when administering this dose? Select all that apply.
- A. It should be administered in the anterior area of the iliac crest.
- B. The onset is immediate.
- C. Use a 27G, 5/8€ needle.
- D. Cephalosporin potentiates the effects of heparin.
- E. Double check the dose with another nurse.
Correct Answer: C,E
Rationale: Subcutaneous heparin should be administered using a 27-gauge, 5/8-inch needle to ensure proper delivery into subcutaneous tissue. Due to the risk of bleeding, the dose should be double-checked with another nurse. The anterior iliac crest is not a standard site (abdomen is preferred), onset is not immediate (takes hours), and cephalosporins do not potentiate heparin's effects.
The nurse is caring for a client with acute arterial occlusion of the left lower extremity. To prevent further tissue damage, it is important for the nurse to observe for which of the following:
- A. Blood pressure and heart rate changes
- B. Gradual or acute loss of sensory and motor function
- C. Metabolic acidosis
- D. Swelling in the left lower extremity
Correct Answer: B
Rationale: Acute arterial occlusion causes ischemia, leading to loss of sensory (numbness) and motor function (weakness) in the affected limb. Monitoring for these changes is critical to detect progression and prevent tissue damage. Blood pressure/heart rate, metabolic acidosis, and swelling are less specific or late findings.
What therapeutic outcome does the nurse expect for a client who has received a premedication of glycopyrrolate (Robinul)?
- A. Increased heart rate.
- B. Increased respiratory rate.
- C. Decreased secretions.
- D. Decreased amnesia.
Correct Answer: C
Rationale: Glycopyrrolate is an anticholinergic that reduces salivary and respiratory secretions, improving airway management during surgery.