Nokea
An intravenous dose of lorazepam is prescribed for a client. Which data from the client's history would indicate the need to consult with the primary health care provider before administering the medication?
- A. Glaucoma
- B. Hypothyroidism
- C. Diabetes mellitus
- D. Coronary artery disease
Correct Answer: A
Rationale: Lorazepam is a benzodiazepine and is contraindicated in clients who are comatose, with preexisting central nervous system (CNS) depression, with uncontrolled severe pain, and those with narrow-angle glaucoma. It is also contraindicated if hypersensitivity or cross-sensitivity with other benzodiazepines exists. It is also not prescribed for clients who are pregnant or breast-feeding.
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The nurse is developing a community health education program about sexually transmitted diseases. Which information about women who acquire gonorrhea should be included?
- A. Women are more reluctant than men to seek medical treatment.
- B. Gonorrhea is not easily transmitted to women who are menopausal.
- C. Women with gonorrhea are usually asymptomatic.
- D. Gonorrhea is usually a mild disease for women.
Correct Answer: C
Rationale: Women with gonorrhea are often asymptomatic, which increases the risk of delayed treatment and complications, a key point for education.
A client who had transurethral resection of the prostate complains of dribbling urine after his Foley catheter is removed on the second postoperative day. The nurse notes that the client had $200 \mathrm{~mL}$ of urine output in the last 8 hours with a $1,000 \mathrm{~mL}$ intake. Which of the following interventions is a priority for the nurse at this time?
- A. Apply a condom catheter
- B. Assess for bladder distention
- C. Obtain a urine specimen for culture
- D. Teach the client Kegel exercises
Correct Answer: B
Rationale: Low urine output and dribbling post-TURP suggest possible bladder distention, which requires immediate assessment to prevent complications. Other interventions may follow based on findings.
The mother of a neonate delivered at 36 weeks' gestation asks why the neonate is being treated for sepsis when no infection is present. Which of the following responses by the nurse is most appropriate?
- A. The neonate may have an infection that we haven't identified yet.'
- B. Premature neonates are more susceptible to infections.'
- C. This is a precautionary measure because the neonate is premature.'
- D. Antibiotics are given to all neonates born before 37 weeks.'
Correct Answer: C
Rationale: Treating a 36-week neonate for sepsis is often precautionary due to their increased risk of infection, even without confirmed infection, to prevent complications.
You assess your family as having a deficit in terms of their instrumental activities of daily living (ADLs). Which healthcare professional would you most likely refer this family to in order to address this deficit?
- A. A social worker
- B. A physical therapist
- C. An occupational therapist
- D. A speech therapist
Correct Answer: C
Rationale: Occupational therapists specialize in helping individuals improve their ability to perform instrumental activities of daily living (e.g., managing finances, cooking), making them the most appropriate referral for this deficit.
A client develops an irregular heart rate. Which statement made by the client who has developed an irregular heart rate indicates to the nurse that the client is ready for learning?
- A. I feel weak with an irregular pulse.
- B. What is it like to have a pacemaker?
- C. All my medications will be changed now.
- D. How can this heart rate problem affect me?
Correct Answer: D
Rationale: Learning depends on two things: physical and emotional readiness to learn. A good time to teach is when the client indicates an interest in learning, is motivated, and is physically capable of concentrating on learning. Option 4 addresses the client's readiness because the client is directly asking about the disorder. Option 1 indicates that the client is potentially physically incapable of learning at this time. The client indicates wanting to learn about pacemakers in option 2; however, the client has formed a hasty conclusion because the need for a pacemaker has not been determined. In option 3, by assuming that the medications will change, the client is emotionally unprepared for learning because the statement is based on incomplete data.