Nokea
A patient has been diagnosed with acute gastritis in a clinic. Which of the following medications would be contraindicated for this patient?
- A. Naproxen sodium (Naprosyn)
- B. Calcium carbonate
- C. Clarithromycin (Biaxin)
- D. Furosemide (Lasix)
Correct Answer: A
Rationale: Naproxen sodium is a nonsteroidal anti-inflammatory drug that can cause inflammation of the upper GI tract. For this reason, it is contraindicated in a patient with gastritis. Gastritis involves inflammation of the stomach lining, and medications like Naproxen can exacerbate this condition. Calcium carbonate is an antacid that can help neutralize stomach acid and may actually provide relief for gastritis symptoms. Clarithromycin is an antibiotic used to treat H. pylori infection, a common cause of gastritis. Furosemide is a loop diuretic used to treat conditions like edema and hypertension, not directly contraindicated in gastritis.
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A client with a new colostomy is being taught how to care for the colostomy bag. Which statement from the client indicates the need for more education?
- A. I can clean the skin around the ostomy site with soap and water when I change the bag.
- B. I should irrigate the stoma regularly to avoid buildup of gas and odor.
- C. I need to wait 30 minutes after I irrigate to replace the colostomy bag.
- D. I should change the bag when it is one-third to one-fourth full.
Correct Answer: C
Rationale: A client with a new colostomy requires education on proper colostomy care. Waiting 30 minutes after irrigating to replace the colostomy bag is unnecessary. The client may reapply the bag once the skin is dry. Cleaning the skin around the ostomy site with soap and water, irrigating the stoma regularly to prevent gas and odor buildup, and changing the bag when it is one-third to one-fourth full are appropriate actions. Therefore, the statement indicating the need for more education is the one suggesting a specific time interval for bag replacement after irrigation.
A patient is scheduled for a magnetic resonance imaging (MRI) scan for suspected lung cancer. Which of the following is a contraindication to the study for this patient?
- A. The patient is allergic to shellfish.
- B. The patient has a pacemaker.
- C. The patient suffers from claustrophobia.
- D. The patient takes antipsychotic medication.
Correct Answer: B
Rationale: The correct answer is that the patient has a pacemaker. A pacemaker is a contraindication to MRI scanning due to the interference with the magnetic fields of the MRI scanner. This interference can potentially deactivate the pacemaker, putting the patient at risk. Patients with cardiac implantable electronic devices (CIED) are at risk for inappropriate device therapy, device heating/movement, and arrhythmia during MRI. This necessitates special precautions such as scheduling in a CIED blocked slot or having electrophysiology nurse or technician support. It is important to ensure that the patient's pacemaker is MRI conditional before proceeding with the scan. The other choices, such as being allergic to shellfish, suffering from claustrophobia, or taking antipsychotic medication, are not direct contraindications to undergoing an MRI scan for suspected lung cancer.
A patient comes to the emergency department with abdominal pain. Work-up reveals the presence of a rapidly enlarging abdominal aortic aneurysm. Which of the following actions should the nurse expect?
- A. The patient will be admitted to the medicine unit for observation and medication.
- B. The patient will be admitted to the day surgery unit for sclerotherapy.
- C. The patient will be admitted to the surgical unit and resection will be scheduled.
- D. The patient will be discharged home to follow-up with his cardiologist in 24 hours.
Correct Answer: C
Rationale: A rapidly enlarging abdominal aortic aneurysm is at significant risk of rupture, which can be life-threatening. The standard treatment for a rapidly enlarging abdominal aortic aneurysm is surgical intervention to prevent rupture. Therefore, the appropriate action for the nurse to expect is that the patient will be admitted to the surgical unit, and resection will be scheduled. Observation and medication (Choice A) are not sufficient for a rapidly enlarging aneurysm, and sclerotherapy (Choice B) is not typically used for aortic aneurysms. Discharging the patient home (Choice D) would be inappropriate and dangerous given the risk of rupture.
A patient is getting discharged from a skilled nursing facility (SNF). The patient has a history of severe COPD and PVD. The patient is primarily concerned about his ability to breathe easily. Which of the following would be the best instruction for this patient?
- A. Deep breathing techniques to increase oxygen levels.
- B. Cough regularly and deeply to clear airway passages.
- C. Cough following bronchodilator utilization.
- D. Decrease CO2 levels by increasing oxygen intake during meals.
Correct Answer: C
Rationale: The correct answer is to instruct the patient to cough following bronchodilator utilization. In COPD and PVD patients, bronchodilators help to open up the airways, making coughing more effective in clearing secretions from the lungs. This instruction can aid in improving the patient's ability to breathe by enhancing airway clearance. Deep breathing techniques (Choice A) may help increase oxygen levels but may not directly address the patient's immediate concern of breathing difficulty. Coughing regularly and deeply (Choice B) can be beneficial, but the timing following bronchodilator use is more crucial to maximize its effectiveness. Decreasing CO2 levels by increasing oxygen intake during meals (Choice D) does not directly address the patient's concern about breathing ease or the role of bronchodilators in improving cough effectiveness.
Rhogam is most often used to treat____ mothers that have a ____ infant.
- A. RH positive, RH positive
- B. RH positive, RH negative
- C. RH negative, RH positive
- D. RH negative, RH negative
Correct Answer: C
Rationale: Rhogam is administered to RH-negative mothers who have an RH-positive infant to prevent the development of anti-RH antibodies in the mother's system. Choice A (RH positive, RH positive) is incorrect because Rhogam is not used when both mother and infant are RH positive. Choice B (RH positive, RH negative) is incorrect because Rhogam is used when the mother is RH negative, not RH positive. Choice D (RH negative, RH negative) is incorrect as Rhogam is not typically needed if both mother and infant are RH negative.