Nokea
An adult has completed an alcohol detoxification program and is being discharged with disulfiram (Antabuse). Which statement that the client makes indicates a need for more teaching?
- A. I have learned my lesson. I won't drink more than two beers.'
- B. I will not use mouthwash while I am taking Antabuse.'
- C. I should take the Antabuse every day.'
- D. If I have to go to the emergency room for any reason, I will tell them I take Antabuse.'
Correct Answer: A
Rationale: Planning to drink alcohol (even minimally) while on disulfiram indicates misunderstanding, as it causes severe reactions with alcohol. Other statements show proper understanding.
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Which laboratory result would be expected during the emergent phase of a burn injury?
- A. Glucose 100 mg/dl
- B. Potassium 3.5 mEq/l
- C. Sodium 142 mEq/l
- D. Albumin 4.2 gm/dl
Correct Answer: A
Rationale: Glucose levels rise as a result of the stress response during the emergent phase. Answers B, C, and D are within normal range. K+ and Na+ would be elevated, whereas albumin would be lowered during the emergent period due to increased permeability.
A client who is terminally ill has been receiving high doses of an opioid analgesic for the past month. As death approaches and the client becomes unresponsive to verbal stimuli, what orders would the nurse expect from the health care provider?
- A. Decrease the analgesic dosage by half
- B. Discontinue the analgesic
- C. Continue the same analgesic dosage
- D. Prescribe a less potent drug
Correct Answer: C
Rationale: Continue the same analgesic dosage. Dying patients who have been in chronic pain will probably continue to experience pain even though they cannot communicate their experience. Pain medication should be continued at the same dose, if effective.
The nurse is teaching a woman the normal changes of pregnancy. Which statement by the woman indicates correct understanding?
- A. There is decreased oxygen consumption during pregnancy.'
- B. There is an increased rate of peristalsis in the GI tract.'
- C. I will have a 50% increase in blood volume.'
- D. My metabolic rate will decrease.'
Correct Answer: C
Rationale: Pregnancy increases blood volume by about 50% to support fetal circulation, a correct understanding. Oxygen consumption and metabolic rate increase, and peristalsis slows.
The nurse is reviewing client assignments on a medical/surgical unit.
The nurse determines that the assignment is appropriate if the nursing assistant is caring for which of the following clients?
- A. A client with AIDS dementia complex who requires a urine specimen.
- B. A client complaining of postoperative pain after repair of a torn rotator cuff.
- C. A client with GI bleeding due to a duodenal ulcer receiving packed cells.
- D. A client with type I diabetes receiving prednisone for a herniated disk.
Correct Answer: A
Rationale: Strategy: Assign clients with standard, unchanging procedures. (1) correct-standard, unchanging procedure (2) assign to the RN (3) assign to the RN (4) assign to the RN
An eight-year-old receiving chemotherapy for six months.
Which of the following responses by the nurse is BEST?
- A. Are you afraid of dying?'
- B. Why do you ask that question?'
- C. Only God knows that answer.'
- D. We won't leave you alone.'
Correct Answer: A
Rationale: Strategy: Remember therapeutic communication. (1) correct-encourages ventilation of thoughts and feelings regarding the concern (2) inappropriate (3) ignores the child's concern with dying (4) ignores the child's concern with dying