Nokea
Magnetic resonance imaging has been ordered for a client. Which factor should the nurse report to the physician?
- A. The client states she had an allergic reaction to iodine.
- B. The client has a pacemaker.
- C. The client wears a hearing aid.
- D. The client takes digoxin.
Correct Answer: B
Rationale: A pacemaker is a contraindication for MRI due to magnetic interference, requiring immediate physician notification to ensure safety.
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The nurse is reinforcing discharge teaching for the parents of an infant with tetralogy of Fallot. Which of the following actions should the nurse include to reduce the incidence of hypercyanotic spells? Select all that apply.
- A. Dress the infant in warm clothing and blankets
- B. Encourage smaller, frequent feedings
- C. Intervene quickly to prevent the infant from crying excessively
- D. Promote a quiet period on waking in the morning
- E. Turn the infant frequently during sleep
Correct Answer: B,C,D
Rationale: Smaller feedings, preventing crying, and quiet periods reduce oxygen demand, minimizing hypercyanotic spells. Warm clothing and frequent turning do not directly prevent spells.
Parents of a 7 year-old child call the clinic nurse because their daughter was sent home from school because of a rash. The child had been seen the day before by the provider and diagnosed with Fifth Disease (erythema infectiosum). What is the most appropriate action by the nurse?
- A. Tell the parents to bring the child to the clinic for further evaluation
- B. Refer the school officials to printed materials about this viral illness
- C. Inform the teacher that the child is receiving antibiotics for the rash
- D. Explain that this rash is not contagious and does not require isolation
Correct Answer: D
Rationale: Explain that this rash is not contagious and does not require isolation. Fifth Disease is not contagious once the rash appears, except in specific cases.
The nurse is teaching the client the appropriate way to use a metered dose inhaler. Which observation indicates the client needs additional teaching?
- A. The client takes a deep breath while depressing the canister
- B. The client holds the canister two finger widths from the mouth
- C. The client waits 30 seconds before repeating the inhalation
- D. The client exhales slowly and deeply
Correct Answer: C
Rationale: When using a metered dose inhaler, the client should wait 1-2 minutes between puffs to ensure proper absorption, not 30 seconds. Answer C indicates a need for additional teaching. Answers A, B, and D describe correct techniques for inhaler use.
The nurse is acting as a preceptor for a student nurse in the labor and delivery unit. Which action by the student would require correction by the nurse?
- A. Removing gloves prior to removing isolation gown
- B. Using a nail brush to scrub underneath artificial nails
- C. Using alcohol-based hand sanitizer instead of washing hands when entering and exiting client room
- D. Washing hands and not wearing gloves when preparing medications in the med room
Correct Answer: B
Rationale: Artificial nails harbor bacteria, and scrubbing underneath is inadequate; they should be avoided in labor and delivery. Other actions align with infection control protocols.
Medication administration record
Allergies: None
Medications Time
Gabapentin: 300 mg orally, every 8 hours 0700, 1500, and 2300
Hydrocodone/acetaminophen: (5 mg/325 mg) orally, every 4 hours Every 4 hours prn
Acetaminophen: 1,000 mg IV, every 6 hours 0600, 1200, 1800, and 2400
Phenytoin: 100 mg orally, every 12 hours 0700 and 1900
The practical nurse on the neurosurgery step-down unit is assisting the registered nurse in the care of a stable client with a closed head injury who is 1 day post-craniotomy. The practical nurse prepares to administer the 7:00 AM medications and reviews the client’s medication administration record. Which prescription prompts the practical nurse to contact the prescribing health care provider for clarification?
- A. Acetaminophen 1,000 mg IV, every 6 hours
- B. Gabapentin 300 mg orally, every 8 hours
- C. Hydrocodone/acetaminophen (5 mg/325 mg) orally, every 4 hours PRN
- D. Phenytoin 100 mg orally, every 12 hours
Correct Answer: A
Rationale: Acetaminophen 1,000 mg IV is unusual for routine post-craniotomy pain and risks overdose if combined with oral hydrocodone/acetaminophen, requiring clarification. Other medications are standard.