Nokea
A nurse prepared the 9:00 A.M. medications for his clients and then was called off the unit briefly before he was able to administer them. Who may administer the medications to the clients now?
- A. Any licensed nurse assigned to the unit and familiar with the clients
- B. A pharmacy technician certified to administer medications
- C. The nurse who prepared them
- D. The nurse manager of the unit
Correct Answer: C
Rationale: The nurse who prepared the medications must administer them to ensure accountability and familiarity with the preparation.
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Assessment of a client with a history of stroke reveals that the client understands and follows commands but answers questions with incorrect word choices. The nurse documents the presence of which communication deficit?
- A. Aphasia
- B. Apraxia
- C. Dysarthria
- D. Dysphagia
Correct Answer: A
Rationale: Aphasia (A) is a language disorder causing difficulty with word choice or expression, common in stroke affecting language centers. The client’s ability to follow commands but use incorrect words suggests expressive aphasia. Apraxia (B) affects motor planning, dysarthria (C) impairs speech articulation, and dysphagia (D) involves swallowing difficulties, none of which match the described deficit.
The nurse reinforces teaching about self-management strategies for a client with urge incontinence. Which of the following statements indicate that teaching has been effective? Select all that apply.
- A. I am going to join a walking program to lose excess weight.
- B. I may have dry mouth as a side effect from the oxybutynin.
- C. I really need caffeine to get myself going in the morning.
- D. I should perform Kegel exercises several times daily.
- E. I will void every 2 hours until I am having fewer accidents.
Correct Answer: A,B,D,E
Rationale: Weight loss (A) reduces bladder pressure, oxybutynin’s dry mouth side effect (B) is correct, Kegel exercises (D) strengthen pelvic floor muscles, and scheduled voiding (E) prevents urgency. Caffeine (C) irritates the bladder, worsening incontinence, indicating ineffective teaching.
A client admitted with glaucoma is being treated with miotic (pilocarpine) eye drops. Following administration of the medication, the nurse will note:
- A. Dilation of the pupils
- B. Diminished redness of the sclera
- C. Decreased edema of the cornea
- D. Constriction of the pupils
Correct Answer: D
Rationale: Miotics, such as pilocarpine, are administered to the client with glaucoma to cause pupillary constriction, thereby lowering intraocular pressure. Answer A is incorrect because miotics constrict the pupil. Answer B is incorrect because miotics do not diminish redness. Answer C is incorrect because miotics do not decrease edema of the cornea.
The client complains of frequent insomnia affecting her ability to rest well. Which of the following factors or lifestyle choices in her assessment history most likely contributes to her inability to sleep?
- A. Having a slight snack at bedtime
- B. Heart disease prevention of one baby aspirin each day
- C. Reading in bed prior to going to sleep
- D. Smoking 1½ packs of filtered cigarettes each day
Correct Answer: D
Rationale: Nicotine in cigarettes is a stimulant, disrupting sleep and likely contributing to insomnia, unlike snacks, aspirin, or reading.
A client diagnosed with endometrial cancer is receiving brachytherapy. Which interventions should the nurse anticipate for this client? Select all that apply.
- A. Cluster care to limit each staff member's time in the room
- B. Instruct the client to be up and around in the room but not to leave the room
- C. Remind family members and visitors to limit close contact with the client
- D. Use protective shielding, if available, when providing direct client care
- E. Wear a radiation badge while in the client's room to measure radiation exposure
Correct Answer: A,C,D,E
Rationale: Brachytherapy involves internal radiation, requiring precautions to minimize exposure. Clustering care (A) reduces staff exposure time. Limiting visitor contact (C) protects others from radiation. Protective shielding (D) and radiation badges (E) ensure safety and monitor exposure. Ambulation (B) is restricted to prevent dislodging the radiation source.