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Metoclopramide (Reglan) is ordered as a premedication for a client about to undergo a gastroduodenoscopy. The nurse expects which of the following as the primary therapeutic effect?
- A. Increased gastric pH.
- B. Increased gastric emptying.
- C. Reduced anxiety.
- D. Inhibited respiratory secretions.
Correct Answer: B
Rationale: Metoclopramide promotes gastric emptying, which is beneficial before gastroduodenoscopy to reduce the risk of aspiration and improve visualization.
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The nurse prepares a teaching plan for a client about crutch walking using a two-point gait pattern. Which of the following should the nurse include?
- A. Advance a crutch on one side and then advance the opposite foot; repeat on the opposite side.
- B. Advance a crutch on one side and simultaneously advance and bear weight on the opposite foot; repeat on the opposite side.
- C. Advance both crutches together and then follow by lifting both lower extremities to the level of the crutches.
- D. Advance both crutches together and then follow by lifting both lower extremities past the level of the crutches.
Correct Answer: B
Rationale: The two-point gait involves simultaneous advancement of one crutch and the opposite foot, mimicking natural walking.
The nurse is preparing a staff education program about medication reconciliation. Which of the following information should the nurse include? Select all that apply.
- A. Discontinued medications should be included while performing medication reconciliation.
- B. Medications taken on an as-needed basis can be excluded from this process.
- C. New medication orders should be compared with the current list.
- D. Medication reconciliation should be performed after the client has been discharged.
- E. Over-the-counter (OTC) medications should be included in the medication reconciliation.
Correct Answer: A,C,E
Rationale: Medication reconciliation includes discontinued medications, new orders, and OTC medications to ensure a complete and accurate list; it should occur at admission, transfer, and discharge, and PRN medications should not be excluded.
The surgeon orders cefazolin (Ancef) 1 g to be given I.V. at 7:30 a.m. when the client's surgery is scheduled at 8:00 a.m. What is the primary reason to start the antibiotic exactly at 7:30 a.m.?
- A. Legally the medication has to be given at the ordered time.
- B. The antibiotic is most effective in preventing infection if it is given 30 to 60 minutes before the operative incision is made.
- C. The postoperative dose of Ancef needs to be started exactly 8 hours after the preoperative dose of Ancef.
- D. The peak and titer levels are needed for antibiotic therapy.
Correct Answer: B
Rationale: Administering cefazolin 30 to 60 minutes before incision ensures optimal tissue levels to prevent surgical site infections. Timing is critical for prophylactic efficacy, not legal requirements or postoperative dosing schedules.
Which complication should the nurse monitor for in a client with a new ileal conduit?
- A. Stoma prolapse.
- B. Urinary retention.
- C. Bladder spasms.
- D. Renal colic.
Correct Answer: A
Rationale: Stoma prolapse is a potential complication of an ileal conduit, requiring surgical correction if severe.
The nurse should assess the client with Ménière'sdisease for the intended outcomes of which of the following medications that are commonly used to manage the disease? Select all that apply.
- A. Antihistamines.
- B. Antiemetics.
- C. Diuretics.
- D. Non-steroidal anti-inflammatory drugs (NSAIDs).
- E. Antipyretics.
Correct Answer: A,B,C
Rationale: Common medications for Ménière'sdisease include antihistamines (e.g., meclizine) to reduce vertigo, antiemetics to control nausea, and diuretics to reduce inner ear fluid, all aimed at symptom management.