Nokea
Contraindications to the administration of tissue plasminogen activator (t-PA) include which of the following?
- A. Age greater than 60 years.
- B. History of cerebral hemorrhage.
- C. History of heart failure.
- D. Cigarette smoking.
Correct Answer: B
Rationale: A history of cerebral hemorrhage is an absolute contraindication to t-PA due to the risk of bleeding. Age, heart failure, and smoking are not contraindications.
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The client with Addison's disease should anticipate the need for increased glucocorticoid supplementation in which of the following situations:
- A. Returning to work after a weekend.
- B. Going on vacation.
- C. Having oral surgery.
- D. Having a routine medical checkup.
Correct Answer: C
Rationale: Oral surgery is a stressful event requiring increased glucocorticoid supplementation to prevent adrenal crisis.
A 56-year-old female is currently receiving radiation therapy to the chest wall for recurrent breast cancer. She has pain while swallowing and burning and tightness in her chest. The nurse should further assess the client for indications of:
- A. Hiatal hernia.
- B. Stomatitis.
- C. Radiation enteritis.
- D. Esophagitis.
Correct Answer: D
Rationale: Pain while swallowing and chest burning/tightness suggest esophagitis, a common side effect of chest wall radiation due to irritation of the esophageal mucosa.
A sedentary, obese, middle-aged client is recovering from a right iliac blood clot. The nurse should develop a discharge plan with the client that will focus on participating in which of the following activities? Select all that apply.
- A. Aerobic activity
- B. Strength training
- C. Weight control
- D. Stress management
Correct Answer: A,C,D
Rationale: Rationales: A) Aerobic activity (e.g., walking) improves circulation and reduces clot recurrence. C) Weight control decreases venous pressure and clot risk. D) Stress management reduces sympathetic activation, aiding vascular health. B) Strength training is less critical for clot management and may be contraindicated initially.
Cimetidine (Tagamet) may also be used to treat hiatal hernia. The nurse should understand that this drug is used to prevent which of the following?
- A. Esophageal reflux.
- B. Dysphagia.
- C. Esophagitis.
- D. Ulcer formation.
Correct Answer: C
Rationale: Cimetidine, an H2-receptor antagonist, reduces gastric acid production, helping to prevent esophagitis caused by acid reflux in hiatal hernia.
What is a key nursing intervention for a client receiving peritoneal dialysis?
- A. Monitor for signs of peritonitis.
- B. Restrict protein intake.
- C. Administer anticoagulants.
- D. Limit ambulation.
Correct Answer: A
Rationale: Peritonitis is a serious complication of peritoneal dialysis, requiring vigilant monitoring.