Nokea
A client with sickle cell anemia is admitted to the labor and delivery unit during the first phase of labor. The nurse should anticipate the client's need for:
- A. Supplemental oxygen
- B. Fluid restriction
- C. Blood transfusion
- D. Delivery by Caesarean section
Correct Answer: A
Rationale: Sickle cell anemia increases oxygen demand during labor, often requiring supplemental oxygen.
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The nurse is preparing to discharge a client who is taking an MAOI. The nurse should instruct the client to:
- A. Wear protective clothing and sunglasses when outside
- B. Avoid over-the-counter cold and hayfever preparations
- C. Drink at least eight glasses of water a day
- D. Increase his intake of high-quality protein
Correct Answer: B
Rationale: MAOIs interact dangerously with OTC cold and hayfever medications containing sympathomimetics, risking hypertensive crisis.
The nurse is reviewing a new client's medication orders. Which order would prompt the nurse to notify the health care provider?
- A. allopurinol 300 mg PO daily
- B. potassium chloride 20 mEq PO daily
- C. warfarin (Coumadin) 50 mg PO daily
- D. metoprolol (Lopressor) 50 mg PO daily
Correct Answer: C
Rationale: A 50 mg dose of warfarin is unusually high and likely a dosing error, requiring provider clarification. Other orders are within typical ranges.
The nurse in the ER has received report of four clients en route to the emergency department. Which client should the nurse see first? A client with:
- A. Third-degree burns to the face and neck area, with singed nasal hairs
- B. Second-degree burns to each leg and thigh area, who is alert and oriented
- C. A chemical burn that has been removed and liberally flushed before admission
- D. An electrical burn entering and leaving on the same side of the body
Correct Answer: A
Rationale: Third-degree burns to the face and neck with singed nasal hairs suggest airway burns, a life-threatening condition requiring immediate airway assessment and management.
During the change of shift, the oncoming nurse notes a discrepancy in the number of percocette listed and the number present in the narcotic drawer. The nurse's first action should be to:
- A. Notify the hospital pharmacist
- B. Notify the nursing supervisor
- C. Notify the Board of Nursing
- D. Notify the director of nursing
Correct Answer: B
Rationale: A narcotic discrepancy requires reporting to the supervisor for investigation.
Nurses must be familiar with the American Nurses Association (ANA) Code of Ethics for Nurses. The nurse understands that which ethical principle is defined as the nurse's duty to do no harm? Fill in the blank.
- A. Nonmaleficence
- B. Bneficence
- C. autonomy
Correct Answer: A
Rationale: Nonmaleficence is the ethical principle of doing no harm, a core duty in nursing practice.