Nokea
How should the nurse prepare a patient who is to receive a Schilling test for pernicious anemia?
- A. Administer radioactive cobalamin and measure its excretion time
- B. Measure antigen-antibody immune complexes
- C. Measure serum ferritin and total iron-binding capacity
- D. Administer folate and evaluate folate content in a blood serum sample
Correct Answer: A
Rationale: The correct answer is A. To prepare a patient for a Schilling test for pernicious anemia, the nurse should administer radioactive cobalamin and measure its excretion time. This test is specifically designed to assess the absorption of vitamin B12. Choices B, C, and D are incorrect because they do not align with the preparation and procedure of a Schilling test. Measuring antigen-antibody immune complexes, serum ferritin, or total iron-binding capacity, as well as administering folate and evaluating folate content, are not part of the Schilling test protocol.
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A nurse is administering testosterone to a patient with hypogonadism. What outcome indicates that the treatment is having the desired effect?
- A. Increased libido
- B. Increased muscle mass
- C. Improved secondary sexual characteristics
- D. Decreased sperm count
Correct Answer: C
Rationale: The correct answer is C: 'Improved secondary sexual characteristics.' Testosterone therapy in patients with hypogonadism typically leads to improved secondary sexual characteristics, which include increased muscle mass and libido. While increased libido (choice A) and increased muscle mass (choice B) are effects of testosterone therapy, they are more specific outcomes related to secondary sexual characteristics. Decreased sperm count (choice D) would not be an expected outcome of testosterone therapy for hypogonadism, as testosterone is essential for sperm production.
What is the best method to identify which type of stroke the client has?
- A. Obtain a 12-lead electrocardiogram STAT
- B. Obtain a blood specimen for electrolytes and blood cultures
- C. Ask the client about current allergies
- D. Obtain a cranial computerized tomogram (CT) STAT
Correct Answer: D
Rationale: The correct answer is to obtain a cranial computerized tomogram (CT) STAT. A cranial CT scan is the best method to quickly identify the type of stroke a client is experiencing. Options A, B, and C are not appropriate for identifying the type of stroke as they are not specific to assessing stroke types.
What is the common denominator of all forms of heart failure?
- A. Pulmonary edema
- B. Jugular venous distention
- C. Peripheral edema
- D. Reduced cardiac output
Correct Answer: D
Rationale: The correct answer is D: Reduced cardiac output. All forms of heart failure share the common denominator of reduced cardiac output, which leads to inadequate tissue perfusion. Pulmonary edema (choice A) is a consequence of heart failure but not the common denominator. Jugular venous distention (choice B) and peripheral edema (choice C) are signs of heart failure but do not represent the common denominator shared by all forms.
A patient is hospitalized due to nonadherence to an antitubercular drug treatment. Which of the following is most important for the nurse to do?
- A. Observe the patient taking the medications.
- B. Administer the medications parenterally.
- C. Instruct the family on the medication regimen.
- D. Count the number of tablets in the bottle daily.
Correct Answer: A
Rationale: In this scenario, the most crucial action for the nurse to take is to observe the patient taking the medications. This ensures that the patient is actually consuming the prescribed antitubercular drugs, addressing the issue of nonadherence directly. Administering the medications parenterally (intravenously or intramuscularly) is not necessary unless there are specific medical reasons requiring this route of administration. Instructing the family on the medication regimen is important for support but may not directly address the patient's nonadherence. Counting the number of tablets in the bottle daily is not as effective as directly observing the patient taking the medications to ensure compliance.
When educating a patient starting on oral contraceptives, what should the nurse include regarding the medication's effectiveness?
- A. Oral contraceptives are 100% effective when taken correctly.
- B. Oral contraceptives are effective immediately after starting.
- C. Oral contraceptives are less effective if taken with certain antibiotics.
- D. Oral contraceptives are less effective if taken with food.
Correct Answer: C
Rationale: The correct answer is C. Oral contraceptives can be less effective when taken with certain antibiotics due to potential drug interactions. It is crucial for patients to be informed about this to consider additional contraceptive methods during antibiotic therapy. Choice A is incorrect because while oral contraceptives are highly effective, they are not 100% foolproof. Choice B is incorrect as it may give the impression that immediate protection is conferred, which is not the case. Choice D is incorrect as taking oral contraceptives with food does not significantly impact their effectiveness.