Nokea
A client with stress incontinence should be advised:
- A. to purchase absorbent undergarments.
- B. that Kegel exercises might help.
- C. that effective surgical treatments are nonexistent.
- D. that behavioral therapy is ineffective.
Correct Answer: B
Rationale: Kegel exercises, tightening and releasing the pelvic floor muscles, might improve stress incontinence. Choice A is not an appropriate treatment for stress incontinence. Several effective surgical treatments exist. Lifestyle and dietary modifications can also be helpful.
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The LPN is about to give 100 mg Lopressor (metoprolol) to a client. Before administering the drug, he takes the patient's vitals, which are as follows: Pulse: 58, Blood Pressure: 90/62, Respirations: 18/minute. What action should the LPN take?
- A. Give the client half the prescribed dose and report the findings to the RN on duty.
- B. Give the client double the dose and report the findings to the RN on duty.
- C. Administer the drug and report the findings to the RN on duty.
- D. Hold the drug and report the findings to the RN on duty.
Correct Answer: D
Rationale: Lopressor is given to treat hypertension, and a pulse of 58 and a blood pressure of 90/62 are considered low. To prevent the client from bottoming out, the drug should be held and the findings reported to the RN, who should consult with the attending physician. LPNs should never adjust client dosing, as that is outside of their scope of practice.
The nurse is initiating an IV infusion of lactated Ringer's (LR) for the client in shock. What is the purpose of LR for this client?
- A. Increase fluid volume and urinary output
- B. Draw water from the cells into the blood vessels
- C. Provide dextrose and nutrients to prevent cellular death
- D. Replace potassium and magnesium for cardiac stabilization
Correct Answer: A
Rationale: A: LR is an isotonic crystalloid solution containing multiple electrolytes in approximately the same concentration as plasma. It enters the cells from the blood, provides fluids, and increases urinary output. B: A hypertonic solution draws fluid from the cells into the vascular compartment; LR is isotonic. C: LR alone does not contain dextrose. Formulations with dextrose are available. D: Magnesium is not a component of LR.
An allergic reaction is classified as what type of pharmacological effect?
- A. a therapeutic effect
- B. a side effect
- C. an adverse effect
- D. an incompatibility
Correct Answer: C
Rationale: An allergic reaction is considered an adverse effect, as it is unintended and requires treatment. A side effect is also undesired but is somewhat expected, and a side effect does not require intervention.
The LPN is caring for a client taking Lipitor (Atorvastatin). Which of these statements would indicate that the client may need reinforced teaching?
- A. I take my Lipitor with a glass of milk after my breakfast.
- B. I take my Lipitor and wait 30 minutes before taking my other medications.
- C. I take my Lipitor 30 minutes after I eat something.
- D. I take my Lipitor and my other morning medications with my grapefruit juice at breakfast.
Correct Answer: D
Rationale: Grapefruit juice should be avoided when taking Lipitor. Grapefruit juice blocks the enzymes needed to breakdown the drug, which leads to excessive amounts of the drug in the body.
The 5-year-old is receiving an IV infusion of D5 with 0.45 NaCl at 100 mL/hr. Which assessment findings suggest excessive parenteral fluid intake? Select all that apply.
- A. Dyspnea
- B. Lethargy
- C. Gastric distention
- D. Crackles in lung bases
- E. Temperature of 102°F (38.9°C)
Correct Answer: A,B,D
Rationale: A: Dyspnea indicates fluid volume overload and occurs from fluid rapidly shifting between the intracellular and extracellular compartments. B: Lethargy and change in level of consciousness can occur from fluid shifting in brain cells. C: Gastric distention can occur from excessive oral (not IV) fluid intake or infection. D: Crackles indicate fluid volume overload and occur from fluid rapidly shifting into the alveoli. E: An elevated temperature is a sign of fluid volume deficit, not excess.