Nokea
A patient is being treated in the telemetry unit for cardiac disease. The patient is to receive propranolol hydrochloride (Inderal) 20 mg PO at 9 AM. The nurse finds him wheezing with a nonproductive cough and shortness of breath.
INITIALLY, the nurse should
- A. hold the medication and count the respirations.
- B. hold the medication and call the physician.
- C. take an apical pulse and then give the medication.
- D. give the medication as ordered.
Correct Answer: A
Rationale: Strategy: Determine the outcome of each answer choice. (1) correct-side effects include increased airway resistance, patient is experiencing bronchospasm, should assess then call the physician (2) should assess the patient's condition first (3) experiencing a side effect, medication should not be given (4) medication should be held, experiencing a side effect
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The physician has prescribed hydralazine (Apresoline) for a client with acute glomerulonephritis. Which finding indicates that the drug is having the desired effect?
- A. The client's appetite has improved.
- B. Creatinine levels have returned to normal.
- C. The client's blood pressure has decreased.
- D. Urinary output is amber in color.
Correct Answer: C
Rationale: Apresoline (hydralazine) is an antihypertensive; therefore, a decrease in blood pressure indicates the medication is working. Answers A, B, and D indicate that the overall condition of the client is improving, but they are not the result of the medication.
A 3 year-old child diagnosed as having celiac disease attends a day care center. Which of the following would be an appropriate snack?
- A. Cheese crackers
- B. Peanut butter sandwich
- C. Potato chips
- D. Vanilla cookies
Correct Answer: C
Rationale: Children with celiac disease should eat a gluten free diet. Potato chips are naturally gluten-free, unlike the other options which contain wheat-based ingredients.
Which of the following instructions should be included in the teaching for the client with arthritis?
- A. Avoid exercise because it fatigues the joints.
- B. Take prescribed anti-inflammatory medications with meals.
- C. Alternate heat and cold packs to the affected joints.
- D. Avoid weight bearing activity.
Correct Answer: B
Rationale: Taking anti-inflammatory medications with meals reduces gastrointestinal irritation, a key teaching point for arthritis management. Exercise and weight-bearing activities are encouraged, and heat/cold alternation is not universally recommended.
A client who is diagnosed with cystitis has been given a prescription for phenazopyridine (Pyridium). She asks the nurse why she has been given this medication. What should the nurse reply?
- A. Pyridium is an antibiotic that will kill the bacteria causing your infection.'
- B. Pyridium is an analgesic that will make you less aware of the pain and discomfort.'
- C. Pyridium is a urinary tract anesthetic that will kill the pain until the antibiotics have had time to work.'
- D. Pyridium will help to prevent kidney damage from the bladder infection.'
Correct Answer: C
Rationale: Phenazopyridine is a urinary tract anesthetic, relieving pain and burning during urination until antibiotics resolve cystitis. It's not an antibiotic, analgesic, or kidney protectant.
The nurse is caring for a client with a pressure ulcer.
- A. Which intervention is most effective for promoting healing of a stage III pressure ulcer?
- B. Apply a hydrocolloid dressing.
- C. Cleanse the wound with hydrogen peroxide.
- D. Reposition the client every 4 hours.
- E. Administer oral antibiotics.
Correct Answer: A
Rationale: A hydrocolloid dressing maintains a moist environment, promoting healing in a stage III pressure ulcer. Hydrogen peroxide is cytotoxic, repositioning every 2 hours is standard, and antibiotics are only used for infection.