Nokea
A nurse is preparing to replace a nearly empty container of total parenteral nutrition (TPN) for a patient. There has been a delay in receiving the new TPN solution from the pharmacy. Which of the following solutions should the nurse infuse until the next TPN solution is available? Which solution should the nurse infuse during TPN delay?
- A. Lactated Ringer's.
- B. 0.9% sodium chloride.
- C. Sodium chloride.
- D. Dextrose 10% in water.
Correct Answer: D
Rationale: The correct answer is D: Dextrose 10% in water. During a delay in receiving TPN, it is important to provide a source of glucose to prevent hypoglycemia. Dextrose 10% in water provides a source of glucose for the patient. Lactated Ringer's (A) and 0.9% sodium chloride (B) are isotonic solutions but do not provide glucose. Sodium chloride (C) is a saline solution and does not provide any nutritional value. Therefore, Dextrose 10% in water is the most appropriate choice to prevent hypoglycemia in this situation.
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A nurse is caring for a patient who has a history of heart failure and is receiving furosemide. Which of the following laboratory results should the nurse monitor? Which lab result should the nurse monitor for furosemide?
- A. Serum potassium
- B. Serum calcium
- C. Serum magnesium
- D. Serum sodium
Correct Answer: A
Rationale: The correct answer is A: Serum potassium. Furosemide is a loop diuretic that can cause potassium loss through increased urine output. Monitoring serum potassium levels is crucial to prevent hypokalemia, which can lead to cardiac arrhythmias in a patient with a history of heart failure. Serum calcium (B) and magnesium (C) are not directly affected by furosemide use. Serum sodium (D) monitoring is important for other conditions but not specific to furosemide therapy in this case.
A nurse in a coronary care unit is admitting a patient who has had CPR following a cardiac arrest. The patient is receiving lidocaine IV at 2 mg/min. When the patient asks the nurse why he is receiving that medication, the nurse should explain that it has which of the following actions? Why is the patient receiving lidocaine?
- A. Relieves pain.
- B. Slows intestinal motility.
- C. Dissolves blood clots.
- D. Prevents dysrhythmias.
Correct Answer: D
Rationale: The patient is receiving lidocaine to prevent dysrhythmias after experiencing a cardiac arrest. Lidocaine is a class IB antiarrhythmic drug that stabilizes the cardiac cell membrane, reducing the likelihood of abnormal electrical activity and dysrhythmias. It does not relieve pain, slow intestinal motility, or dissolve blood clots. Therefore, the correct answer is D, as it directly addresses the purpose of administering lidocaine in this specific clinical scenario.
A nurse in the emergency department is attending to a patient exhibiting symptoms of a myocardial infarction. Which of the following actions should the nurse prioritize? Which action should the nurse prioritize for myocardial infarction?
- A. Initiate oxygen therapy.
- B. Obtain a blood sample.
- C. Attach the leads for a 12-lead ECG.
- D. Insert an IV catheter.
Correct Answer: A
Rationale: The correct answer is A: Initiate oxygen therapy. In a myocardial infarction, the priority is to ensure adequate oxygen supply to the heart muscle to prevent further damage. Oxygen therapy helps increase oxygen delivery to the heart, reducing the workload on the heart muscle. This action can potentially limit the size of the infarction and improve the patient's outcome. Obtaining a blood sample (B) can provide valuable information but is not as urgent as ensuring oxygen supply. Attaching leads for a 12-lead ECG (C) is important for diagnosing the myocardial infarction but does not directly address the immediate need for oxygen. Inserting an IV catheter (D) may be necessary for administering medications, but oxygen therapy takes precedence in this situation.
A nurse is caring for a patient who is receiving chemotherapy. Which of the following laboratory values should the nurse report to the provider? Which lab value should the nurse report during chemotherapy?
- A. Hemoglobin 12 g/dL
- B. Platelet count 50,000/mm3
- C. WBC 8,000/mm3
- D. Serum creatinine 1.0 mg/dL
Correct Answer: B
Rationale: The correct answer is B: Platelet count 50,000/mm3. During chemotherapy, patients are at risk for developing thrombocytopenia, a condition characterized by low platelet count. Thrombocytopenia can lead to increased risk of bleeding and bruising. Therefore, a platelet count of 50,000/mm3 is concerning and should be reported to the provider for further evaluation and management.
A: Hemoglobin of 12 g/dL is within normal range and not typically a concern during chemotherapy.
C: WBC count of 8,000/mm3 is within normal range and may not be a priority during chemotherapy unless there are other concerning symptoms.
D: Serum creatinine of 1.0 mg/dL is within normal range and not directly related to chemotherapy effects on the patient's blood counts.
A nurse is caring for a patient who is 9 days postoperative following a total laryngectomy. The nurse removes the patient's NG tube and initiates oral feedings. Which of the following statements should the nurse make? Which statement should the nurse make post-laryngectomy?
- A. You should have no trouble swallowing fluids.
- B. It is no longer possible for you to choke on or aspirate food.
- C. I will add a thickener to your liquids to prevent aspiration.
- D. Tuck your chin when you swallow so you won't choke.
Correct Answer: D
Rationale: The correct answer is D: "Tuck your chin when you swallow so you won't choke." After a laryngectomy, patients have altered anatomy that can affect swallowing. Tucking the chin helps close off the airway during swallowing, reducing the risk of choking. This technique directs the food towards the esophagus instead of the trachea, minimizing the risk of aspiration. Choices A, B, and C are incorrect because they do not address the specific swallowing precautions needed post-laryngectomy. Choice A assumes normal swallowing function, which may not be the case. Choice B is inaccurate as aspiration can still occur post-laryngectomy. Choice C is not specific to the patient's individual needs and may not be necessary.