Nokea
A female client is treated for trichomoniasis with metronidazole (Flagyl). The nurse instructs the client that:
- A. The medication should not alter the color of the urine.
- B. She should discontinue oral contraceptive use during this treatment.
- C. She should avoid alcohol during treatment and for 24 hours after completion of the drug.
- D. Her partner does not need treatment.
Correct Answer: C
Rationale: Metronidazole can cause a disulfiram-like reaction with alcohol, so avoiding alcohol during and 24 hours after treatment is critical.
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A client is experiencing symptoms of early alcohol withdrawal. The client's blood pressure is 150/85 mm Hg and the pulse is 98 bpm. The nurse should:
- A. Administer lorazepam (Ativan).
- B. Apply arm and leg restraints.
- C. Assign an unlicensed assistive personnel to sit with the client.
- D. Notify the physician.
Correct Answer: D
Rationale: Notifying the physician is the priority to obtain orders for managing alcohol withdrawal symptoms, which may require medications like lorazepam.
A client has been prescribed digoxin (Lanoxin). Which of the following symptoms should the nurse tell the client to report as a potential indication of digoxin toxicity?
- A. Urticaria.
- B. Shortness of breath.
- C. Visual disturbances.
- D. Hypertension.
Correct Answer: C
Rationale: Visual disturbances, such as blurred or yellow vision, are classic signs of digoxin toxicity, requiring immediate reporting.
What ethical principle below is accurately paired with a way that ethical principle is applied into nursing practice?
- A. Justice: Equally dividing time and other resources among a group of clients
- B. Beneficence: Doing no harm during the course of nursing care
- C. Veracity: Fully answering the client's questions without any withholding of information
- D. Fidelity: Upholding the American Nurses Association's Code of Ethics
Correct Answer: C
Rationale: Veracity is accurately paired with fully answering the client's questions without withholding information, as it emphasizes truthfulness in nursing practice. Justice involves fair treatment, not just equal time ; Beneficence involves promoting good, not just avoiding harm ; Fidelity is about keeping promises, not specifically the ANA Code .
A nurse is assessing a client who is receiving clozapine (Clozaril). The nurse reviews the chart below. What should the nurse do next?
- A. Give the clozapine, and tell the client to lie down.
- B. Withhold the clozapine, and tell the client to go to an exercise group.
- C. Administer the clozapine, and notify the physician.
- D. Withhold the clozapine, and notify the physician.
Correct Answer: D
Rationale: Clozapine requires monitoring for agranulocytosis; abnormal findings (e.g., low white blood cell count) warrant withholding the drug and notifying the physician to prevent serious complications.
Your client is in the special care area of your hospital with multiple trauma and severe bodily burns. This 45 year old male client has an advance directive that states that the client wants all life saving measures including cardiopulmonary resuscitation and advance cardiac life support, including mechanical ventilation. As you are caring for the client, the client has a complete cardiac and respiratory arrest. This client has little of no chance for survival and they are facing imminent death according to your professional judgement, knowledge of pathophysiology and your critical thinking. You believe that all life saving measures for this client would be futile. What is the first thing that you, as the nurse, should do?
- A. Call the doctor and advise them that the client's physical status has significantly changed and that they have just had a cardiopulmonary arrest.
- B. Begin cardiopulmonary resuscitation other emergency life saving measures.
- C. Notify the family of the client's condition and ask them what they should be done for the client.
- D. Insure that the client is without any distressing signs and symptoms at the end of life.
Correct Answer: B
Rationale: The client's advance directive clearly states a desire for all life-saving measures, including CPR and advanced cardiac life support. Despite the nurse's professional judgment about futility, the nurse is legally and ethically obligated to follow the advance directive and initiate CPR immediately in the event of a cardiac and respiratory arrest. Notifying the doctor or family or ensuring comfort are secondary actions after initiating life-saving measures as per the client's documented wishes.