Nokea
Clozapine (Clozaril) therapy has been initiated for a client with schizophrenia who has been unresponsive to other antipsychotics. The client states, 'Why do I have to have a blood test every week?' Which of the following responses by the nurse would be most appropriate?
- A. Weekly blood tests are necessary to determine safe dosage and to monitor the effect of the medication on the blood.'
- B. Weekly blood tests are done so that you can receive another week's supply of the medication.'
- C. Your physician will want to know how well you are personally progressing with the medication therapy.'
- D. Everyone who takes this drug must go through the same procedure because it is required by the drug company.'
Correct Answer: A
Rationale: Weekly blood tests monitor for agranulocytosis, a serious side effect of clozapine, ensuring safe dosing and early detection of blood abnormalities.
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A child with partial- and full-thickness burns is admitted to the pediatric unit. Which of the following should be the priority at this time?
- A. Preventing wound infection.
- B. Evaluating vital signs frequently.
- C. Maintaining fluid and electrolyte balance.
- D. Managing the child's pain.
Correct Answer: C
Rationale: Maintaining fluid and electrolyte balance is the priority in burn care to prevent hypovolemic shock due to significant fluid loss.
After your assessment of your client and the need to transfer your client from the bed to the chair, what is the best and safest way to transfer this paralyzed client when you suspect that you will need the help of another for the client's first transfer out of bed?
- A. Use a slide board.
- B. Use a mechanical lift.
- C. Use a gait belt.
- D. Notify the client's doctor that the client cannot be safely transferred by you.
Correct Answer: B
Rationale: For a paralyzed client requiring assistance, a mechanical lift is the safest transfer method, minimizing risk of injury to both the client and staff.
An adult client has been placed on a fluid restriction of 1200 mL per day. The nurse discusses the fluid restriction with the dietitian and then plans to allow the client to have how many milliliters of fluid from 7:00 am to 3:00 pm?
- A. 400 mL
- B. 600 mL
- C. 800 mL
- D. 1000 mL
Correct Answer: B
Rationale: When a client is on fluid restriction, the nurse informs the dietary department and discusses the allotment of fluid per shift with the dietitian. When calculating how to distribute a fluid restriction, the nurse usually allows half of the daily allotment (600 mL) during the day shift, when the client eats two meals and takes most medications. Another two-fifths (480 mL) is allotted to the evening shift, with the balance (120 mL) allowed during the nighttime.
A client with a fractured femur is placed in skeletal traction. The nurse should assess the client for which of the following complications?
- A. Pressure ulcers.
- B. Deep vein thrombosis.
- C. Hypovolemia.
- D. Infection at the pin sites.
Correct Answer: B,D
Rationale: Skeletal traction increases the risk of deep vein thrombosis due to immobility and infection at pin sites due to skin penetration.
The school nurse planning to give a class on testicular self-examination (TSE) at a local high school should include which instruction to the participants?
- A. Perform the self-examination every other month.
- B. Perform the self-examination after a cold shower.
- C. Expect the self-examination to be slightly painful.
- D. Roll the testicle between the thumb and forefinger.
Correct Answer: D
Rationale: TSE is a self-screening examination for testicular cancer, which predominantly affects men in their late teens and twenties. The self-examination is performed once a month, as is breast self-examination. As an aid to remember to do it, the examination should be done on the same day each month. The scrotum is held in one hand and the testicle is rolled between the thumb and forefinger of the other hand. The self-examination should not be painful. It is easiest to do either during or after a warm shower (or bath) when the scrotum is relaxed.