Nokea
A nurse is caring for a client who has a contusion of the brainstem and reports thirst. The client's urinary output was 4,000 mL over the past 24 hr. The nurse should anticipate a prescription for which of the following IV medications?
- A. Nitroprusside
- B. Furosemide
- C. Epinephrine
- D. Desmopressin
Correct Answer: D
Rationale: The correct answer is D: Desmopressin. The client with a contusion of the brainstem and increased urinary output of 4,000 mL in 24 hrs is likely experiencing diabetes insipidus (DI), which is characterized by excessive urination and thirst. Desmopressin is a synthetic form of antidiuretic hormone (ADH) that helps reduce urine production and control thirst in DI. Nitroprusside (A) is a vasodilator used to treat hypertensive emergencies, not related to DI. Furosemide (B) is a loop diuretic that increases urine output and would worsen the client's condition. Epinephrine (C) is a sympathomimetic drug used in emergencies like anaphylaxis, not for DI. Therefore, Desmopressin is the most appropriate choice to address the client's symptoms.
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A nurse in the emergency department is monitoring a client who is receiving dopamine to treat hypovolemic shock. Which of the following findings should the nurse identify as an indication for increasing the client's dopamine dosage?
- A. Blood pressure 90/50 mm Hg
- B. Oxygen saturation 95%
- C. Heart rate 60/min
- D. Respiratory rate 14/min
Correct Answer: A
Rationale: The correct answer is A: Blood pressure 90/50 mm Hg. Dopamine is a vasopressor used to increase blood pressure in hypovolemic shock. A low blood pressure reading of 90/50 mm Hg indicates inadequate perfusion, warranting an increase in dopamine dosage to improve cardiac output. Oxygen saturation (B) and respiratory rate (D) are not direct indicators for adjusting dopamine dosage. A heart rate of 60/min (C) may be within normal limits depending on the client's condition.
A nurse is assessing a client who has a chest tube connected to a closed water-seal drainage system. Which of the following findings should the nurse report to the provider?
- A. Constant bubbling in the water seal chamber
- B. Intermittent bubbling in the suction chamber
- C. Clear drainage of 50 mL over 8 hours
- D. Mild pain at the insertion site
Correct Answer: A
Rationale: The correct answer is A: Constant bubbling in the water seal chamber. Constant bubbling in the water seal chamber indicates an air leak in the chest tube system, which can lead to lung collapse or pneumothorax. This finding should be reported to the provider immediately for further evaluation and intervention. Intermittent bubbling in the suction chamber (choice B) is expected and indicates that the suction is working properly. Clear drainage of 50 mL over 8 hours (choice C) is within normal limits and does not require immediate reporting. Mild pain at the insertion site (choice D) is common after a chest tube insertion and can be managed with pain medication.
A nurse is caring for a client who is postoperative and develops respiratory depression after receiving morphine for pain control. Which of the following medications should the nurse expect the provider to prescribe?
- A. Flumazenil
- B. Calcium gluconate
- C. Diphenhydramine
- D. Naloxone
Correct Answer: D
Rationale: The correct answer is D: Naloxone. Naloxone is an opioid antagonist that reverses the effects of opioids, including respiratory depression. Therefore, the nurse should expect the provider to prescribe naloxone to counteract the respiratory depression caused by morphine. Flumazenil (A) is a benzodiazepine antagonist and would not be effective in this situation. Calcium gluconate (B) is used to treat calcium deficiencies and would not address respiratory depression. Diphenhydramine (C) is an antihistamine and not indicated for reversing opioid-induced respiratory depression.
A nurse is reviewing the medical record of a client who has acute gout. The nurse should expect an increase in which of the following laboratory results?
- A. Intrinsic factor
- B. Uric acid
- C. Chloride level
- D. Creatinine kinase
Correct Answer: B
Rationale: The correct answer is B: Uric acid. In acute gout, there is an accumulation of uric acid crystals in the joints, leading to inflammation and pain. As a result, the uric acid levels in the blood increase. Monitoring uric acid levels helps in diagnosing and managing gout.
Explanation for other choices:
A: Intrinsic factor - Intrinsic factor is related to vitamin B12 absorption, not gout.
C: Chloride level - Chloride level is not directly impacted by acute gout.
D: Creatinine kinase - Creatinine kinase is an enzyme related to muscle breakdown, not specifically affected by gout.
A nurse manager is providing an in-service to a group of newly licensed nurses about the use of personal protective equipment. Which of the following statements by a newly licensed nurse indicates an understanding of the teaching?
- A. I should wear a gown to remove linens from a client's be '
- B. Sterile gloves are required when administering an IM injection.'
- C. I should wear goggles when irrigating a woun '
- D. I should use both hands to recap a needle.'
Correct Answer: C
Rationale: The correct answer is C: "I should wear goggles when irrigating a wound." This indicates an understanding of the teaching as goggles protect the eyes from splashes and sprays. Wearing goggles during wound irrigation helps prevent potential eye exposure to contaminated fluids, reducing the risk of infection.
Choice A is incorrect because wearing a gown to remove linens is unnecessary for personal protective equipment during this task. Choice B is incorrect as sterile gloves are required for clean procedures like wound care, not for administering IM injections. Choice D is incorrect because using both hands to recap a needle increases the risk of needle-stick injuries.