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In administering NSAID adjunctive therapy to an elderly client with cancer, the nurse must monitor:
- A. BUN and creatinine.
- B. creatinine and calcium.
- C. Hgb and Hct.
- D. BUN and CFT.
Correct Answer: A
Rationale: Elder adults might be more at risk for gastric and renal toxicity, increasing among elder adults.
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The LPN is preparing to ambulate a client post total knee replacement. Which of the following actions should the nurse perform prior to ambulating the client?
- A. Assist the client to a sitting position at the edge of the bed.
- B. Have the client march in place for 30 seconds.
- C. Have the client raise his arms above his head.
- D. Ask the client the last time he fell.
Correct Answer: A
Rationale: The client should be assisted to a sitting position prior to standing. This action can prevent orthostatic hypotension. Marching in place and raising the client's arms above his head are not necessary prior to ambulation. While knowing about the client's last fall can be important, it is not the priority action before ambulating the client.
Which of the following is least relevant when reviewing the client's risk for elimination impairment?
- A. current medications
- B. ambulation abilities
- C. family history
- D. hydration status
Correct Answer: C
Rationale: The client's family history is least relevant when determining the risk for elimination impairment.
Which of the following individuals may legally give informed consent?
- A. an 86-year-old male with advanced Alzheimer's disease
- B. a 14-year-old girl needing an appendectomy who is not an emancipated minor
- C. a 72-year-old female scheduled for a heart transplant
- D. a 6-month-old baby needing bowel surgery
Correct Answer: C
Rationale: Only competent adults can legally give informed consent. The 72-year-old female is presumed competent unless stated otherwise. An individual with advanced Alzheimer's lacks decision-making capacity, a non-emancipated minor cannot consent, and infants are legally incapable of consenting; their guardians must provide consent.
The nurse is observing the nursing student caring for the client with an artificial eye. What action by the student nurse would require intervention?
- A. Positioning the client lying down to remove the prosthetic eye
- B. Drying the prosthetic eye with gauze before reinsertion
- C. Cleansing the prosthetic eye with normal saline solution
- D. Telling the client to remove the prosthetic eye weekly for cleaning
Correct Answer: B
Rationale: B: The prosthetic eye should be moist to facilitate insertion; drying it could cause trauma to the socket. A: Lying down aids safe removal. C: Normal saline is appropriate for cleansing. D: Periodic removal every 1-3 weeks is recommended.
The client reports pain in the right leg even though it was amputated. Which complementary therapy should the nurse use to control the phantom pain associated with the client's amputation?
- A. A small dose of alprazolam at 8-hour intervals in addition to prescribed oxycodone and acetaminophen q6h pm
- B. A high-fiber diet and 2000 mL fluid intake in 24 hours while taking hydromorphone at 4- to 6-hour intervals pm
- C. Progressive relaxation exercises three times daily in addition to use of a transdermal patch of fentanyl
- D. A local anesthetic as a nerve block in addition to prescribed long-acting oxycodone
Correct Answer: C
Rationale: C: Progressive relaxation is a complementary therapy that aids phantom pain relief with analgesics. A: Alprazolam is conventional, not complementary. B: Diet addresses opioid side effects, not pain. D: Nerve blocks are conventional medical interventions.