Nokea
A healthcare professional is preparing to draw a blood specimen from an adult client's central line. All of the following actions for this procedure are correct EXCEPT:
- A. Disconnect the current infusion
- B. Clean the cap with alcohol and attach a 5 cc syringe
- C. Draw 5 cc of a blood sample to discard
- D. Flush with saline after the sample
Correct Answer: B
Rationale: When drawing a blood specimen from a central line, the healthcare professional should disconnect any infusions that are currently running and that could contaminate the specimen. It is important to use a minimum size of a 10 cc syringe when using a central line to avoid placing too much pressure on the catheter. Cleaning the cap with alcohol and attaching a 5 cc syringe is not appropriate as a larger syringe size should be used for this procedure. Drawing 5 cc of a blood sample to discard and flushing with saline after the sample are correct steps in the process of drawing a blood specimen from a central line.
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A client has started sweating profusely due to intense heat. His overall luid volume is low and he has developed electrolyte imbalance. This client is most likely suffering from:
- A. Malignant hyperthermia
- B. Heat exhaustion
- C. Heat stroke
- D. Heat cramps
Correct Answer: B
Rationale: Heat exhaustion occurs when a person has enough diaphoresis that he becomes dehydrated. Intense sweating can cause both luid and electrolyte imbalances. Untreated heat exhaustion canlead to heat stroke, which results in organ damage, loss of consciousness, or death.
The nurse is teaching an HIV-positive client who just delivered an HIV-positive full-term infant. Which statement by the client indicates a need for further teaching?
- A. The antiviral medicines will cure my baby in about six months.
- B. There is a low risk of my baby transmitting the virus to household members.
- C. I should completely avoid breastfeeding my baby and purchase formula instead.
- D. Pneumonia and herpes simplex are common secondary infections my baby may develop.
Correct Answer: A
Rationale: HIV is not curable; antivirals manage but do not eliminate the virus. Other statements are correct regarding transmission, breastfeeding, and infection risks.
A client who is taking an antipsychotic medication is preparing for discharge. To facilitate health promotion for this client, what instruction should the nurse provide?
- A. Avoid prolonged exposure to the sun.
- B. Adhere to a strict tyramine-restricted diet.
- C. Recognize the signs and symptoms of a relapse of depression.
- D. Have therapeutic blood levels drawn because the medication has a narrow therapeutic range.
Correct Answer: A
Rationale: Antipsychotic medications improve the thought processes and behaviors of a client with psychotic symptoms, especially a client with schizophrenia. Photosensitivity is a side effect of antipsychotic medications. Maintaining a strict tyramine-restricted diet is applicable to monoamine oxidase inhibitors (MAOIs). Antipsychotics are not used to treat depression. Lithium is a mood stabilizer that requires monitoring of medication blood levels.
A client with a hiatal hernia asks the nurse about fluids that are safe to drink and that will not irritate the gastric mucosa. What fluid should the nurse tell the client to drink?
- A. Apple juice
- B. Orange juice
- C. Tomato juice
- D. Grapefruit juice
Correct Answer: A
Rationale: Substances that are irritating to the client with hiatal hernia include tomato products and citrus fruits, which should be avoided. Because caffeine stimulates gastric acid secretion, beverages that contain caffeine, such as coffee, tea, cola, and cocoa, are also eliminated from the diet.
A client diagnosed with anxiety disorder is prescribed buspirone orally. When the client reports that it is difficult to swallow the tablets, the nurse provides which instruction to promote compliance?
- A. Crush the tablets before taking them.
- B. Mix the tablet uncrushed in applesauce.
- C. Purchase the liquid preparation with the next refill.
- D. Call the primary health care provider for a change in medication.
Correct Answer: A
Rationale: Buspirone tablets may be crushed and administered without regard to meals, making this the most effective instruction to promote compliance for a client who finds swallowing difficult. Mixing the tablet uncrushed in applesauce does not address the swallowing issue. Buspirone is not available in liquid form, and calling the primary health care provider for a medication change is premature before trying this intervention.