Nokea
A student nurse is developing a care plan for a 23-year-old woman with Meniere's disease. Which of the following would NOT be an expected intervention?
- A. administer narcotic pain medication PRN as ordered
- B. refer client to dietician to plan meals with reduced sodium levels
- C. assist client out of bed to shower and to toilet
- D. encourage client to eat several, similarly sized meals throughout the day
Correct Answer: A
Rationale: Meniere’s disease causes vertigo and hearing loss, not typically requiring narcotic pain medication. Low-sodium diets, assistance with mobility, and balanced meals help manage symptoms.
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Which of the following medication orders requires clarification before the nurse can administer the order?
- A. epinephrine (EpiPen) 0.25 mg IM STAT
- B. heparin 30 units/kg/hr IV infusion for 24 hours
- C. ampicillin (Omnipen) 500 mg PO bid
- D. lorazepam (Ativan) 1.0 mg PO prn
Correct Answer: B
Rationale: Heparin dosing (30 units/kg/hr) is unusually low for anticoagulation (typically 10-20 units/kg/hr). This requires clarification to ensure safety.
A 16-year-old girl presents with peptic ulcers, constipation, low self-esteem, irregular menstrual cycle, and dental erosion. Her weight has fluctuated between 96 and 128 pounds over the past year. The nurse suspects the girl is suffering from
- A. binge eating disorder.
- B. bulimia nervosa.
- C. pernicious anemia.
- D. anorexia nervosa.
Correct Answer: B
Rationale: Bulimia nervosa is characterized by binge-purge cycles, leading to dental erosion, peptic ulcers, irregular menses, and weight fluctuations.
The nurse is caring for a client receiving supplemental oxygen. The effectiveness of the oxygen therapy is best determined by:
- A. The rate of respirations
- B. The absence of cyanosis
- C. Arterial blood gases
- D. The level of consciousness
Correct Answer: C
Rationale: Arterial blood gases provide a direct measure of oxygenation and are the most accurate way to evaluate the effectiveness of oxygen therapy.
A 35-year-old male comes into the clinic after he strains his back at work. The nurse anticipates the physician may suggest which topical anesthetic?
- A. aloe
- B. zinc oxide
- C. hydrocortisone
- D. capsaicin
Correct Answer: D
Rationale: Capsaicin is a topical analgesic used for muscle pain, such as back strain. Aloe, zinc oxide, and hydrocortisone are not anesthetics.
Physician's orders for a client with acute pancreatitis include the following: strict NPO and nasogastric tube to low intermittent suction. The nurse recognizes that witholding oral intake will:
- A. Reduce the secretion of pancreatic enzymes
- B. Decrease the client's need for insulin
- C. Prevent the secretion of gastric acid
- D. Eliminate the need for pain medication
Correct Answer: A
Rationale: Withholding oral intake (NPO) reduces stimulation of the pancreas, thereby decreasing the secretion of pancreatic enzymes that can exacerbate pancreatitis.