Nokea
An adult is diagnosed with hypertension. He is prescribed chlorothiazide (Diuril) 500 mg PO. What nursing instruction is essential for him?
- A. Drink at least two quarts of liquid daily.
- B. Avoid hard cheeses.
- C. Drink orange juice or eat a banana daily.
- D. Do not take aspirin.
Correct Answer: C
Rationale: Chlorothiazide, a diuretic, can cause potassium loss. Consuming potassium-rich foods like orange juice or bananas helps prevent hypokalemia.
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The nurse is functioning in the role of medication nurse during a code. Which should the nurse implement when administering amiodarone for ventricular tachycardia?
- A. Mix the medication in 100 mL of fluid and administer rapidly.
- B. Push the amiodarone directly into the nearest IV port and raise the arm.
- C. Question the physician’s order because it is not ACLS recommended.
- D. Administer via an IV pump based on mg/kg/min.
Correct Answer: D
Rationale: Amiodarone for VT is administered via IV pump (D) per ACLS (e.g., 150 mg over 10 min). Rapid infusion (A) risks hypotension, direct push (B) is incorrect, and questioning (C) is unnecessary.
Because the client is exhibiting signs and symptoms of congestive heart failure (CHF), which position suggested by the nurse is most beneficial for the client at this time?
- A. Supine with knees slightly bent
- B. Side-lying on the right side
- C. Side-lying on the left side
- D. Semi-Fowler's position
Correct Answer: D
Rationale: Semi-Fowler's position (30-45 degrees) reduces preload and eases breathing in CHF.
The nurse identifies the concept of tissue perfusion as a client problem. Which is an antecedent of tissue perfusion?
- A. The client has a history of coronary artery disease (CAD).
- B. The client has a history of diabetes insipidus (DI).
- C. The client has a history of chronic obstructive pulmonary disease (COPD).
- D. The client has a history of multiple fractures from a motor-vehicle accident.
Correct Answer: A
Rationale: CAD (A) directly impairs cardiac perfusion due to atherosclerosis, an antecedent to perfusion issues. DI (B), COPD (C), and fractures (D) are less directly related.
An adult client is admitted with a diagnosis of left-sided congestive heart failure. Which assessment finding would most likely be present?
- A. Distended neck veins
- B. Dyspnea
- C. Hepatomegaly
- D. Pitting edema
Correct Answer: B
Rationale: Dyspnea is a hallmark symptom of left-sided congestive heart failure due to pulmonary congestion. Distended neck veins, hepatomegaly, and pitting edema are more associated with right-sided heart failure.
An adult who is receiving heparin asks the nurse why it cannot be given by mouth. The nurse responds that heparin is given parenterally because:
- A. it is destroyed by gastric secretions.
- B. it irritates the gastric mucosa.
- C. it irritates the intestinal lining.
- D. therapeutic levels can be achieved more quickly.
Correct Answer: AUG
Rationale: Heparin is a protein and is destroyed by gastric secretions, requiring parenteral administration (intravenously or subcutaneously). It does not irritate the gastric or intestinal lining, and while parenteral administration allows faster therapeutic levels, the primary reason is its destruction in the stomach.