Nokea
Cholestyramine resin (Questran Light) is prescribed for the client with an elevated serum cholesterol level. The nurse would instruct the client to take the medication
- A. After meals.
- B. Mixed with fruit juice.
- C. Via rectal suppository.
- D. At least 3 hours before meals.
Correct Answer: B
Rationale: The correct answer is B: Mixed with fruit juice. Cholestyramine resin should be taken mixed with a liquid, such as fruit juice, to prevent esophageal irritation and improve absorption. Taking it with a meal can interfere with nutrient absorption. Taking it via rectal suppository is incorrect as it is an oral medication. Taking it at least 3 hours before meals is not necessary and may lead to decreased effectiveness. Mixing it with fruit juice helps improve tolerability and effectiveness.
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The nurse has inserted a nasogastric tube to the level of the oropharynx and has repositioned the client's head in a flexed-forward position. The client has been asked to begin swallowing. The nurse starts slowly to advance the nasogastric tube with each swallow. The client begins to cough, gag, and choke. Which nursing action would least likely result in proper tube insertion and promote client relaxation?
- A. Continuing to advance the tube to the desired distance
- B. Pulling the tube back slightly
- C. Checking the back of the pharynx using a tongue blade and flashlight.
- D. Instructing the client to breathe slowly and take sips of water.
Correct Answer: A
Rationale: Correct Answer: A
Rationale:
1. The client is experiencing coughing, gagging, and choking, indicating improper tube insertion.
2. Continuing to advance the tube can lead to further discomfort and potential complications.
3. Pulling the tube back slightly allows for reevaluation of placement and prevents further irritation.
4. Checking the back of the pharynx can identify any obstruction or incorrect placement.
5. Instructing the client to breathe slowly and take sips of water can help relax the client and facilitate proper insertion.
A client is suspected of having hepatitis. Which diagnostic test results will assist in confirming this diagnosis?
- A. Decreased erythrocyte sedimentation rate
- B. Elevated serum bilirubin
- C. Elevated hemoglobin
- D. Elevated blood urea nitrogen
Correct Answer: B
Rationale: The correct answer is B: Elevated serum bilirubin. Hepatitis is characterized by liver inflammation, which can lead to impaired bilirubin metabolism and increased levels in the blood. Elevated serum bilirubin is a common finding in hepatitis. Decreased erythrocyte sedimentation rate (Choice A) is not specific to hepatitis. Elevated hemoglobin (Choice C) and elevated blood urea nitrogen (Choice D) are not typically associated with hepatitis and are more indicative of other conditions. In summary, elevated serum bilirubin is a key diagnostic marker for confirming a diagnosis of hepatitis.
Vasopressin (Pitressin) therapy is prescribed for a client with a diagnosis of bleeding esophageal varices. The nurse is preparing to administer the medication to the client. Which of the following essential items is needed during the administration of this medication?
- A. A cardiac monitor
- B. An intubation set
- C. A suction setup
- D. A tracheotomy set
Correct Answer: A
Rationale: The correct answer is A: A cardiac monitor. Vasopressin is a vasoconstrictor medication used to decrease blood flow to the bleeding esophageal varices. It can cause significant changes in blood pressure and heart rate, hence requiring close monitoring of the client's cardiac status. A cardiac monitor is essential to continuously monitor the client's heart rate and rhythm during vasopressin therapy.
B: An intubation set is not necessary for administering vasopressin to a client with bleeding esophageal varices.
C: A suction setup is not directly related to the administration of vasopressin for bleeding esophageal varices.
D: A tracheotomy set is not required for the administration of vasopressin for bleeding esophageal varices.
A Penrose drain is in place on the first postoperative day following a cholecystectomy. Serosanguineous drainage is noted on the dressing covering the drain. Which nursing intervention is most appropriate?
- A. Notify the physician.
- B. Change the dressing.
- C. Circle the amount on the dressing with a pen.
- D. Continue to monitor the drainage.
Correct Answer: B
Rationale: The correct answer is B: Change the dressing. This is the most appropriate intervention because serosanguineous drainage can indicate the need for a dressing change to prevent infection and ensure proper wound healing. Changing the dressing will also allow for better assessment of the drainage and the incision site.
A: Notifying the physician may not be necessary at this stage since serosanguineous drainage is expected in the early postoperative period.
C: Circling the amount on the dressing with a pen does not address the need for a dressing change or further assessment of the drainage.
D: Continuing to monitor the drainage is important, but changing the dressing is the immediate action needed to ensure proper wound care.
The client with cirrhosis has ascites and excess fluid volume. Which measure will the nurse include in the plan of care for this client?
- A. Increase the amount of sodium in the diet.
- B. Limit the amount of fluids consumed.
- C. Encourage frequent ambulation.
- D. Administer magnesium antacids.
Correct Answer: B
Rationale: The correct answer is B: Limit the amount of fluids consumed. In cirrhosis with ascites and excess fluid volume, limiting fluid intake helps reduce fluid overload and prevent further accumulation of fluid in the body. Excess fluid can worsen ascites, leading to complications like respiratory distress and electrolyte imbalances. Increasing sodium intake (A) would worsen fluid retention. Encouraging ambulation (C) is important but not directly related to managing ascites. Administering magnesium antacids (D) is not necessary for addressing fluid volume excess.