Nokea
A terminally ill 82-year-old client in hospice care is experiencing nausea and vomiting because of a partial bowel obstruction. To respect the client's wishes for conservative management of the nausea and vomiting, the nurse should recommend the use of:
- A. A nasogastric (NG) suction tube.
- B. I.V. antiemetics.
- C. Antibiotic laxatives.
- D. A clear liquid diet.
Correct Answer: B
Rationale: I.V. antiemetics are a conservative, effective way to manage nausea and vomiting in hospice care, aligning with the client's preference for non-invasive treatment.
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A nurse is caring for a client who is prescribed a medication with a narrow therapeutic index (NTI). Which action should the nurse take when administering this medication?
- A. Administer the medication as prescribed, ensuring strict adherence to the dosing schedule.
- B. Administer the medication concurrently with herbal supplements to augment its efficacy.
- C. Combine the medication with other medications to enhance its therapeutic effects.
- D. Administer the medication at a higher dose than prescribed to achieve faster results.
Correct Answer: A
Rationale: NTI medications require strict adherence to dosing to maintain therapeutic levels and avoid toxicity.
The nurse is teaching a caregiver how to administer an injection of enoxaparin. Which statement, if made by the caregiver, would require further teaching?
- A. "I will give this injection in the abdomen."
- B. "I should give this injection at a 30 degree angle."
- C. "Acetaminophen is safe while taking this medication for any aches or pains."
- D. "A soft toothbrush should be used while taking this medicine."
Correct Answer: B
Rationale: Enoxaparin is administered subcutaneously at a 90-degree angle, not 30 degrees, to ensure proper absorption.
An airplane crash results in mass casualties. The nurse is directing personnel to tag all victims. Which is normal should be placed on the tag? Select all that apply.
- A. Triage priority.
- B. Identifying information when possible (such as name, age, and address).
- C. Medications and treatments administered.
- D. Presence of jewelry.
- E. Next of kin.
Correct Answer: A,B,C
Rationale: Victim tags should include triage priority, identifying information, and treatments administered to ensure proper care and identification. Jewelry and next of kin are secondary considerations.
Which of the following is a risk factor for hypovolemic shock?
- A. Hemorrhage.
- B. Antigen-antibody reaction.
- C. Gram-negative bacteria.
- D. Vasodilation.
Correct Answer: A
Rationale: Hemorrhage is a primary cause of hypovolemic shock, as it reduces circulating blood volume. Antigen-antibody reactions cause anaphylactic shock, gram-negative bacteria cause septic shock, and vasodilation is a feature of distributive shock.
The nurse should plan to begin rehabilitation efforts for the burn client:
- A. Immediately after the burn has occurred.
- B. After the client's circulatory status has been stabilized.
- C. After the client's pain has been eliminated.
- D. After the client's pain has been eliminated.
Correct Answer: B
Rationale: Rehabilitation begins after stabilizing the client's circulatory status (emergent phase), as this ensures survival and allows focus on recovery. Immediate rehab is unsafe, and complete pain elimination is unrealistic.