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In preparing medications for a client with a gastrostomy tube, the nurse should contact the health care provider before administering which of the following drugs through the tube?
- A. Cardizem SR tablet (diltiazem)
- B. Lanoxin liquid
- C. Os-cal tablet (calcium carbonate)
- D. Tylenol liquid (acetaminophen)
Correct Answer: A
Rationale: Cardizem SR is a 'sustained-release' drug form. Sustained release (controlled-release, long-acting) drug formulations are designed to release the drug over an extended period of time. If crushed, as would be required for gastrostomy tube administration, sustained-release properties and blood levels of the drug will be altered. The provider must substitute another medication.
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The nurse in the emergency department is caring for a newborn who has been vomiting. Which of the following findings may indicate that the newborn is experiencing a bowel obstruction?
- A. green colored vomit
- B. occasional vomiting since birth
- C. tiny streaks of blood in the vomit
- D. vomit coming through the nose
Correct Answer: A
Rationale: Green-colored vomit in a newborn suggests bile, indicating a possible bowel obstruction like malrotation or volvulus. Occasional vomiting , blood streaks , and nasal vomit are less specific.
An 80-year-old woman is having difficulty sleeping. Which nursing action is most appropriate initially?
- A. Ask the physician for an order for a sleeping medication.
- B. Encourage the client to do mild exercises a half hour before going to bed.
- C. Suggest to the client that she not nap during the day.
- D. Recommend the client drink coffee in the evening.
Correct Answer: C
Rationale: Avoiding daytime naps improves nighttime sleep hygiene, a non-pharmacologic initial approach suitable for an elderly client.
At a well baby clinic the nurse is assigned to assess an 8 month-old child. Which of these developmental achievements would the nurse anticipate that the child would be able to perform?
- A. Say 2 words
- B. Pull up to stand
- C. Sit without support
- D. Drink from a cup
Correct Answer: C
Rationale: Sit without support. This is a typical developmental milestone for an 8-month-old.
The clinic nurse is reinforcing teaching to a client who has been prescribed transdermal scopolamine to prevent motion sickness during an upcoming vacation on a cruise ship. Which of the following statements made by the nurse are appropriate? Select all that apply.
- A. Apply the patch when the ship starts moving and not before.'
- B. Dispose of the patch out of reach of children and pets.'
- C. Ensure that the old patch is removed before applying a new one.'
- D. Place the patch on a hairless, clean, dry area behind the ear.'
- E. Wash your hands with soap and water after handling the patch.'
Correct Answer: B,C,D,E
Rationale: Appropriate scopolamine instructions include safe disposal , removing old patches , correct placement , and hand washing . Applying the patch only when moving is incorrect, as it should be applied hours before travel.
The nurse is collecting data on a client with hypertension and essential tremor who received the first dose of propranolol 2 hours ago. Which assessment is most concerning to the nurse?
- A. Client reports a headache
- B. Current blood pressure is 160/88 mm Hg
- C. Heart rate has decreased from 70/min to 60/min
- D. Slight wheezes auscultated during inspiration
Correct Answer: D
Rationale: Wheezing post-propranolol is concerning for bronchospasm, a serious side effect in a patient with no known respiratory history. Headache , elevated BP , and mild heart rate decrease are less urgent.