Nokea
A nurse suspects that a client is experiencing acute acetaminophen toxicity based on assessment of which of the following?
- A. Nausea
- B. Jaundice
- C. Hypertension
- D. Cardiac arrhythmias
- E. Confusion
Correct Answer: A,B,E
Rationale: Signs of acute acetaminophen toxicity include nausea, vomiting, confusion, liver tenderness, hypotension, cardiac arrhythmias, jaundice, and acute hepatic and renal failure.
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A nurse would be especially alert for the development of liver failure in which client when administering acetaminophen?
- A. Client with diabetes
- B. Client who consumes alcohol habitually
- C. Client with hypertension
- D. Client with a urinary tract infection
Correct Answer: B
Rationale: Habitual alcohol consumption increases the risk of liver failure during acetaminophen therapy due to enhanced liver toxicity.
Which of the following drugs is used to decrease the risk of myocardial infarction in patients with unstable angina or previous myocardial infarction?
- A. Aspirin
- B. Diflunisal
- C. Magnesium salicylate
- D. Acetaminophen
Correct Answer: A
Rationale: Aspirin reduces the risk of myocardial infarction in patients with unstable angina or previous myocardial infarction due to its antiplatelet effects.
A nurse is administering a nonopioid analgesic to a client. Which of the following should the nurse perform during the ongoing assessment?
- A. Reassess client's pain rating 30 to 60 minutes after drug administration.
- B. Assess joints for greater mobility.
- C. Check vital signs every 4 hours.
- D. Document pain severity, location, and intensity if pain persists.
- E. Assess the joints for decreased inflammation
Correct Answer: A,B,C,D,E
Rationale: Ongoing assessment includes monitoring pain relief, reassessing pain every 30 to 60 minutes, documenting pain characteristics, checking vital signs every 4 hours, and assessing joints for reduced inflammation and improved mobility.
A nurse suspects that a client is developing salicylism. Which of the following would help confirm this suspicion?
- A. Tinnitus
- B. Bradycardia
- C. Sweating
- D. Impaired vision
- E. Mental confusion
Correct Answer: A,C,E
Rationale: Signs of salicylism include tinnitus, sweating, mental confusion, dizziness, impaired hearing, nausea, vomiting, flushing, rapid breathing, tachycardia, diarrhea, lassitude, drowsiness, respiratory depression, and coma.
A client is scheduled for outpatient surgery. When performing the preoperative teaching with the client, the nurse would instruct the client to avoid taking any salicylates for at least how many days before the surgery?
- A. 3
- B. 5
- C. 7
- D. 10
Correct Answer: C
Rationale: Salicylates should be avoided for at least 7 days before surgery to reduce the risk of postoperative bleeding.