Nokea
Cortisone acetate (Cortone) and fludrocortisone acetate (Florinef Acetate) are prescribed as replacement therapy for a client with Addison's disease. What administration schedule should be followed for this therapy?
- A. Take both drugs three times a day.
- B. Take the entire dose of both drugs first thing in the morning.
- C. Take all the fludrocortisone acetate and two-thirds of the cortisone acetate in the morning, and take the remaining cortisone acetate in the afternoon.
- D. Take half of each drug in the morning and the remaining half of each drug at bedtime.
Correct Answer: C
Rationale: Mimicking diurnal cortisol patterns, most cortisone and all fludrocortisone are taken in the morning, with the remaining cortisone in the afternoon.
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Following a thoracotomy, the client has severe pain. Which of the following strategies for pain management will be most effective for this client?
- A. Repositioning the client immediately after administering pain medication.
- B. Reassessing the client 30 minutes after administering pain medication.
- C. Verbally reassuring the client after administering pain medication.
- D. Readjusting the pain medication dosage as needed according to the client's condition.
Correct Answer: D
Rationale: Readjusting pain medication dosage based on the client's condition ensures adequate pain control, critical for recovery. Repositioning, reassessing, and reassurance are supportive but less effective alone.
Which activity would be appropriate to delegate to unlicensed personnel for a client diagnosed with a myocardial infarction who is stable?
- A. Evaluate the lung sounds.
- B. Help the client identify risk factors for CAD.
- C. Provide teaching on a 2 g sodium diet.
- D. Record the intake and output.
Correct Answer: D
Rationale: Recording intake and output is within the scope of unlicensed personnel, as it involves observation and documentation, not assessment or teaching.
Post-cystectomy, a client asks about the purpose of the ileal conduit. The nurse explains it is to:
- A. Store urine in the bladder.
- B. Divert urine to an external pouch.
- C. Filter blood in the kidneys.
- D. Reabsorb water in the intestines.
Correct Answer: B
Rationale: An ileal conduit diverts urine from the ureters to a stoma, collected in an external pouch.
A 45-year-old single mother of three teenaged boys has metastatic breast cancer. Her parents live 750 miles away and have only been able to visit twice since her initial diagnosis 14 months ago. The progression of her disease has forced the client to consider high-dose chemotherapy. She is concerned about the children's welfare during the treatment. When assessing the client's present support systems, the nurse will be most concerned about the potential problems with:
- A. Denial as a primary coping mechanism.
- B. Support systems and coping strategies.
- C. Decision-making abilities.
- D. Transportation and money for the boys.
Correct Answer: B
Rationale: Limited support systems and coping strategies are a major concern, as the client's isolation and responsibility for her children may hinder her ability to manage treatment and emotional stress.
The nurse should remind family members who are visiting a client with granulocytopenia to:
- A. Visit only if they do not have a cold.
- B. Wash their hands.
- C. Leave the children at home.
- D. Avoid kissing the client on the lips.
Correct Answer: B
Rationale: Hand washing is the most effective way to prevent transmission of pathogens to a granulocytopenic client, who is at high risk for infection. While avoiding colds, leaving children at home, and avoiding kissing are helpful, hand washing is the priority.