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Methotrexate is prescribed for a client with rheumatoid arthritis (RA) who is also taking aspirin. Which is the best explanation for the nurse to provide as to why a second medication has been added?
- A. Methotrexate has less harmful side effects than aspirin.
- B. Methotrexate helps to reduce the side effects of the aspirin therapy.
- C. Methotrexate enhances the effectiveness of the aspirin.
- D. Methotrexate slows the disease progression while aspirin controls the symptoms.
Correct Answer: D
Rationale: Methotrexate slows RA progression, while aspirin manages symptoms, addressing both disease and comfort.
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A client reports to the clinic nurse of recently experiencing symptoms of frequent urination, hunger, and great thirst. What finding(s) would the nurse consider as most significant to report to the healthcare provider? Select all that apply.
- A. Total cholesterol 180 mg/dL (4.7 mmol/L).
- B. Hematocrit 45% (0.45 volume fraction).
- C. Random plasma glucose level 200 mg/dL (11.1 mmol/L).
- D. Hemoglobin A1C 7%.
- E. Serum potassium of 4.2 mEq/L (4.2 mmol/L).
Correct Answer: C,D
Rationale: Elevated glucose and HbA1C indicate diabetes, correlating with the client's symptoms and requiring urgent management.
The nurse is caring for a client in the post anesthesia care unit (PACU) who underwent a thoracotomy two hours ago. The nurse observes vital signs of a heart rate of 140 beats/minute, a respiratory rate of 26 breaths/minute, and a blood pressure of 140/90 mm Hg. Which intervention is most important for the nurse to implement?
- A. Administer IV fluid bolus as prescribed by the healthcare provider.
- B. Encourage the client to splint the Incision with a pillow to cough and deep breathe.
- C. Medicate for pain and monitor vital signs according to protocol.
- D. Apply oxygen at 10 L/minute via non-rebreather mask and monitor pulse oximeter.
Correct Answer: C
Rationale: Pain medication addresses tachycardia and tachypnea likely caused by postoperative pain, stabilizing vital signs.
A client with bilateral carpal tunnel syndrome reports to the nurse that the pain and tingling experienced worsens at night. Which client teaching should the nurse provide?
- A. Notify the healthcare provider as soon as possible.
- B. Wear braces on both wrists during the night.
- C. Elevate the hands on two pillows at night.
- D. Apply cold compresses for 30 minutes before bedtime.
Correct Answer: B
Rationale: Wrist braces maintain a neutral position, reducing median nerve pressure and alleviating nighttime symptoms.
Nurses' Notes
Physical Examination
Vital Signs
Day 1, 0830
Body mass index (BMI) is 31.8 kg/m2
Pain rating of 8 on 0 to 10 scale, in the right foot
Client history has been collected, and the nurse performs a physical assessment and records vital signs
Which finding(s) in the client's health record should the nurse recognize places the client at a greater risk of developing gout? Select all that apply.
- A. Drinks beer nightly
- B. Hypertension
- C. Sleep apnea
- D. Ibuprofen for pain
- E. Daily aspirin
- F. Type 2 diabetes mellitus
- G. osteoarthritis
Correct Answer: A,B,F,G
Rationale: Beer , hypertension , diabetes, osteoarthritis increase uric acid levels or metabolic risks for gout.
History and Physical
Nurses’ notes
Laboratory Results
Flow Sheet
The nurse is caring for a client who was admitted to the hospital with reports of shortness of breath, fever, fatigue, and oral thrush three days ago. The health care provider reviews the laboratory and diagnostic tests with the client and informs of the diagnosis of Pneumocystis pneumonia. The client reports that they recently tested HIV positive. The nurse reviews the client's medical record.
HIV diagnosed 4 months ago with no medications prescribed.
Note added to H&P reporting client wishes to be confidential since family and friends are unaware of the HIV diagnosis
What order(s) should the nurse anticipate being prescribed after an update is reported to the healthcare providers? Select all that apply.
- A. Administer antiemetic
- B. Monitor for adverse reaction to antibiotics
- C. Increase IV fluids to 150 mL/hr
- D. Initiate airborne isolation
- E. Repeat CD4+ T-cell count STAT
Correct Answer: A,B,C
Rationale: Antiemetics , antibiotic monitoring , and increased fluids address emesis, treatment safety, and hydration in Pneumocystis pneumonia.