Nokea
An adult has been taking captopril (Capoten) for hypertension. The client tells the nurse that he has a dry cough and sometimes gets dizzy when he stands up. What conclusions should the nurse make regarding this client?
- A. The client is having severe side effects and should discontinue the drug until after he sees his physician.
- B. Dizziness is a common side effect of antihypertensives. The cough is probably unrelated to the medication.
- C. A dry cough is a common side effect of angiotensin-converting enzyme (ACE) inhibitors. The client should stand up slowly to avoid orthostatic hypotension, a common side effect of antihypertensives.
- D. Cough is a serious side effect and usually results in discontinuing the medication. The dizziness will get better with time.
Correct Answer: C
Rationale: Dry cough and orthostatic hypotension are common ACE inhibitor side effects; slow position changes mitigate dizziness, and cough may require evaluation.
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The nurse is caring for all of the following persons. Which one is most in need of restraints?
- A. An elderly man who is sitting in a chair
- B. A confused postoperative client who is picking at his nasal oxygen and nasogastric (NG) tube
- C. A confused woman who is in bed with the side rails up
- D. An adult who has just returned to the surgical floor from a postanesthesia care unit
Correct Answer: B
Rationale: The confused postoperative client risks dislodging critical tubes, necessitating restraints if non-restraint interventions fail. Others pose lower immediate risk.
A client with a history of increased intracranial pressure is admitted to the hospital for severe headaches. The client suddenly vomits and states, 'That's weird, I didn't even feel nauseated.' Which action should the nurse take next?
- A. Document the amount of emesis
- B. Lower the head of the bed
- C. Notify the supervising registered nurse
- D. Offer an antinausea medication
Correct Answer: C
Rationale: Sudden vomiting without nausea in increased ICP suggests worsening pressure, requiring immediate RN notification (C). Documentation (A), lowering the bed (B), and antiemetics (D) are secondary.
An 80-year-old client is prescribed codeine for a severe cough. The home health nurse is reinforcing instructions on how to prevent the common adverse effects associated with codeine. Which client statements indicate an understanding of how to prevent them? Select all that apply.
- A. I'll be sure to apply sunscreen if I go outside.
- B. I'll drink at least 8 glasses of water a day.
- C. I'll drink decaffeinated coffee so I can sleep at night.
- D. I'll sit on the side of my bed for a few minutes before getting up.
- E. I'll take my medicine with food.
Correct Answer: B,D,E
Rationale: Drinking water (B) prevents constipation, sitting before standing (D) avoids orthostatic hypotension, and taking with food (E) reduces nausea. Sunscreen (A) and decaf coffee (C) are unrelated to codeine effects.
An adult is scheduled for a paracentesis. What should the nurse plan to do immediately before the procedure is started?
- A. Give the client a full glass of water
- B. Have the client empty his/her bladder
- C. Ask the client to empty his/her bowels
- D. Administer diazepam (Valium) as ordered
Correct Answer: B
Rationale: Emptying the bladder before paracentesis prevents accidental puncture of the bladder during needle insertion into the abdominal cavity. Water intake, bowel emptying, or sedation are not immediate pre-procedure priorities.
A non-stress test has been ordered for a pregnant client with diabetes mellitus. Non-stress testing is a part of the diabetic's prenatal care because:
- A. Fetal movement is adversely affected by diabetes.
- B. Maternal insulin levels can have a negative effect on fetal energy.
- C. Diabetes can adversely affect development of placental vessels.
- D. Fetal lung maturity is most easily determined by non-stress testing.
Correct Answer: C
Rationale: Diabetes can impair placental vessel development, reducing oxygen and nutrient delivery to the fetus, necessitating non-stress testing to monitor fetal well-being. Fetal movement and lung maturity are assessed differently, and insulin's effect is indirect.