Nokea
A nurse in an acute care facility is assisting with the development of an in-service about reducing environmental stressors to improve clients' sleep. Which of the following instructions should the nurse include?
- A. Turn on overhead lights briefly when checking IV lines.
- B. Wear shoes with rubber soles.
- C. Open curtains between clients in semiprivate rooms.
- D. Conduct change-of-shift report near the clients' rooms.
Correct Answer: B
Rationale: Rubber-soled shoes reduce noise, improving sleep environment.
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The client is dependent on nicotine and wishes to discontinue smoking.
A nurse is reinforcing teaching with a client who is dependent on nicotine and wishes to discontinue smoking. The nurse should inform the client that which of the following is a manifestation of nicotine withdrawal?
- A. Weight loss
- B. Diaphoresis
- C. Insomnia
- D. Diarrhea
Correct Answer: C
Rationale: Insomnia is a common nicotine withdrawal symptom.
The client has a chlamydial infection and a new prescription for doxycycline. The client reports nausea and vomiting after starting the medication.
A nurse is caring for a client who has a chlamydial infection and a new prescription for doxycycline. The client reports nausea and vomiting after starting the medication. Which of the following recommendations should the nurse make?
- A. Take the medication with calcium-fortified orange juice.
- B. Take the medication with crackers.
- C. Take the medication and then lay down for 30 min.
- D. Take the medication with an antacid.
Correct Answer: B
Rationale: Taking doxycycline with crackers reduces GI upset without affecting absorption.
A nurse is receiving a telephone prescription from a client's provider. Which of the following actions should the nurse take? (Select all that apply)
- A. Instruct another nurse to record the prescription in the medical record.
- B. Ask the provider to spell out the name of the medication.
- C. Withhold the medication until the provider signs the prescription.
- D. Record the date and time of the telephone prescription.
- E. Request that the provider confirm the read-back of the prescription.
Correct Answer: B,D,E
Rationale: Spelling the medication, recording date/time, and confirming read-back ensure accuracy and safety.
The client consumed alcohol 2 days after taking disulfiram.
A nurse is caring for a client who consumed alcohol 2 days after taking disulfiram. The nurse should monitor the client for which of the following findings?
- A. Constipation
- B. Dry skin
- C. Hypotension
- D. Urinary retention
Correct Answer: C
Rationale: Disulfiram-alcohol reaction causes hypotension among other symptoms.
A nurse is contributing to the plan of care for a newly admitted client who has anorexia nervosa. Which of the following interventions should the nurse include?
- A. Monitor the client for 1 hr after meals.
- B. Weigh the client every 2 days.
- C. Check the client's vital signs two times per week.
- D. Allow the client 2 hr to finish meals.
Correct Answer: A
Rationale: Monitoring for 1 hour after meals prevents purging, a key intervention for anorexia.