Nokea
A patient refuses to take his dose of oral medication. The nurse tells the patient that if he does not take the medication that she will administer it by injection. The nurse's comments can result in a charge of:
- A. Malpractice
- B. Assault
- C. Negligence
- D. Battery
Correct Answer: B
Rationale: Threatening to administer medication by injection against the patient's will constitutes assault, as it involves a threat of unwanted contact.
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A client has viral encephalitis and has been prescribed IV acyclovir (Zovirax). What nursing interventions should be used when administering the drug?
- A. Administer at a slow rate.
- B. Assure the client is well hydrated before giving the drug.
- C. Observe for neurotoxicity.
- D. Check the apical heart rate prior to administration.
- E. Infuse cautiously in clients with renal insufficiency.
Correct Answer: A, B, C, E
Rationale: Acyclovir requires slow infusion (A) to prevent phlebitis, adequate hydration (B) to reduce nephrotoxicity, monitoring for neurotoxicity (C), and caution in renal insufficiency (E). Heart rate (D) is unrelated.
The nurse is preparing a client with an axillopopliteal bypass graft for discharge. The client should be taught to avoid:
- A. Using a recliner to rest
- B. Resting in supine position
- C. Sitting in a straight chair
- D. Sleeping in right Sim's position
Correct Answer: C
Rationale: Clients with an axillopopliteal bypass graft should avoid prolonged sitting in a straight chair, as it can compress the graft and impair blood flow. Reclining, supine, or Sim’s positions are less likely to compromise the graft.
The physician has ordered a liver panel for a client with suspected hepatitis. Which laboratory result is most indicative of liver damage?
- A. Elevated ALT
- B. Decreased hemoglobin
- C. Elevated sodium
- D. Decreased potassium
Correct Answer: A
Rationale: Elevated alanine aminotransferase (ALT) is specific to liver damage, as it is released when hepatocytes are injured, common in hepatitis. Hemoglobin, sodium, and potassium are not directly indicative of liver function.
A client with a history of a hiatal hernia is being taught about dietary management. The nurse should encourage the client to:
- A. Eat large meals
- B. Avoid caffeine
- C. Lie down after meals
- D. Eat high-fat foods
Correct Answer: B
Rationale: Caffeine relaxes the lower esophageal sphincter, worsening hiatal hernia symptoms. Small meals, avoiding lying down post-meals, and low-fat foods are recommended.
A client with a history of atrial fibrillation is admitted with complaints of fatigue. The nurse should give priority to:
- A. Monitoring heart rate
- B. Administering pain medication
- C. Monitoring respiratory rate
- D. Administering diuretics
Correct Answer: A
Rationale: Fatigue in atrial fibrillation may indicate reduced cardiac output, so monitoring heart rate is the priority.