Nokea
A nurse cares for an older adult client who has Salmonella food poisoning. The clients vital signs are heart rate: 102 beats/min, blood pressure: 98/56 mm Hg. Which statement by the client indicates a need for additional teaching?
- A. I should not prepare food for others while I am sick.
- B. I will take the ciprofloxacin until the diarrhea has resolved.
- C. I should wash my hands with antibacterial soap before each meal.
- D. I must place my dishes into the dishwasher after each meal.
Correct Answer: B
Rationale: Ciprofloxacin should be taken for 10 to 14 days to treat Salmonella infection and should not be stopped once diarrhea resolves. Clients must complete the full course of antibiotics to prevent recurrence and resistance. Not preparing food for others, washing hands with antibacterial soap, and cleaning dishes thoroughly are correct practices to prevent the spread of infection.
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A nurse cares for a client who is prescribed 5 mg/kg of infliximab (Remicade) intravenously. The client weighs 110 lbs and the pharmacy supplies infliximab 100 mg/10 mL solution. How many milliliters should the nurse administer to this client? (Record your answer using a whole number)
- A. 20 mL
- B. 25 mL
- C. 30 mL
- D. 35 mL
Correct Answer: B
Rationale: The client weighs 110 lbs (50 kg). The dose is 5 mg/kg, so 5 mg/kg ? 50 kg = 250 mg. The pharmacy supplies 100 mg/10 mL, so 250 mg ÷ 100 mg/10 mL = 25 mL.
A nurse reviews the chart of a client who has Crohn's disease and a draining fistula. Which documentation should alert the nurse to urgently contact the provider for additional prescriptions?
- A. Serum potassium of 2.6 mEq/L
- B. Client ate 25% of breakfast meal
- C. White blood cell count of 8200/mm³
- D. Client's weight decreased by 3 pounds
Correct Answer: A
Rationale: A serum potassium level of 2.6 mEq/L is critically low and can lead to serious dysrhythmias, requiring urgent intervention. A normal white blood cell count (8200/mm³) does not warrant immediate action. Reduced meal intake and weight loss are concerning but less urgent than hypokalemia.
After teaching a client who has a new colostomy, the nurse provides feedback based on the client's ability to complete self-care activities. Which statement should the nurse include in this feedback?
- A. I realize that you had a tough time today, but it will get easier with practice.
- B. You cleared the stoma well. Now you need to practice putting on the appliance.
- C. You seem to understand what I taught you today. What else can I help you with?
- D. You seem to understand. Do you want your daughter to care for your ostomy?
Correct Answer: B
Rationale: Feedback should be objective and constructive, acknowledging what was done well (clearing the stoma) and identifying areas for improvement (applying the appliance). General reassurance, vague inquiries, or suggesting someone else manage the ostomy are not constructive.
A nurse assesses a client who is recovering from an ileostomy placement. Which clinical manifestation should alert the nurse to urgently contact the health care provider?
- A. Pale and bluish stoma
- B. Liquid stool
- C. Ostomy pouch intact
- D. Blood-smeared output
Correct Answer: A
Rationale: A pale or bluish stoma indicates potential ischemia or poor perfusion, requiring urgent provider notification. Liquid stool and blood-smeared output are expected after ileostomy placement, and an intact pouch is normal.
After teaching a client who is prescribed adalimumab (Humira) for severe ulcerative colitis, the nurse assesses the client's understanding. Which statement by the client indicates a need for additional teaching?
- A. I will avoid large crowds and people who are sick.
- B. I will take this medication with my breakfast each morning.
- C. Nausea and vomiting are common side effects of this drug.
- D. I must wash my hands after I play with my dog.
Correct Answer: B
Rationale: Adalimumab (Humira) is administered via subcutaneous injection, not orally with meals. Avoiding crowds and sick individuals, recognizing nausea and vomiting as side effects, and practicing good hand hygiene are correct actions, as adalimumab causes immune suppression.