Nokea
Omeprazole (Prilosec), cimetidine (Tagamet), and Maalox are ordered for an adult. When should the nurse plan to administer these drugs?
- A. Give omeprazole (Prilosec) before meals, cimetidine (Tagamet) with meals, and Maalox after meals.
- B. Give omeprazole (Prilosec) with meals, cimetidine (Tagamet) after meals, and Maalox before meals.
- C. Give omeprazole (Prilosec) after meals, cimetidine (Tagamet) before meals, and Maalox with meals.
- D. Give all of the drugs after meals.
Correct Answer: A
Rationale: Omeprazole (PPI) is taken before meals to inhibit acid production, cimetidine (H2 blocker) with meals to reduce acid during digestion, and Maalox (antacid) after meals to neutralize residual acid.
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A nurse is performing the routine daily cleaning of a tracheostomy. During the procedure, the client coughs and displaces the tracheostomy tube. This negative outcome could have been avoided by
- A. placing an obturator at the client's bedside
- B. having another nurse assist with the procedure
- C. fastening clean tracheostomy ties before removing old ties
- D. placing the client in a flat, supine position
Correct Answer: C
Rationale: fastening clean tracheostomy ties before removing old ties. Fastening clean tracheostomy ties before removing old ones will ensure that the tracheostomy is secured during the entire cleaning procedure. The obturator is useful to keep the airway open only after the tracheostomy outer tube is coughed out. A second nurse is not needed. Changing the position may not prevent a dislodged tracheostomy.
A four-year-old is admitted with drooling and an inflamed epiglottis. During the assessment, the nurse would identify which of the following symptoms as indicative of an increase in respiratory distress?
- A. Bradycardia.
- B. Tachypnea.
- C. General pallor.
- D. Irritability.
Correct Answer: B
Rationale: increase in the respiratory rate is an early sign of hypoxia, also for tachycardia
The nurse knows which of the following would be MOST likely to help the family of an emotionally disturbed client manage behaviors at home after discharge from inpatient treatment?
- A. Refer the family to Alliance for the Mentally Ill meetings for educational programs and support groups.
- B. Provide the family with pamphlets that describe the desired action and side effects of medications the client is taking.
- C. Tell the family that it is not their fault that the client behaves inappropriately.
- D. Involve the family in the assessment of the client when s/he is first admitted to the hospital.
Correct Answer: A
Rationale: The Alliance for the Mentally Ill offers ongoing education and support groups, equipping families with skills to manage behaviors long-term. Pamphlets, reassurance, and early involvement are helpful but lack the sustained impact of a support network.
Two new admissions to the unit. One of the new admissions is diagnosed with pneumonia, and the other new patient is diagnosed with AIDS.
Which of the following assignments is MOST appropriate?
- A. Assign both patients to one room with one nurse caring for both patients.
- B. Place both patients in the same room and assign the care to different nurses.
- C. Assign each patient to a private rooms and assign both clients to one nurse.
- D. Place each client in a private room and assign each patient to a different nurse.
Correct Answer: D
Rationale: Strategy: All answers are implementations. Determine the outcome of each answer choice. Is it desired? (1) increases the potential for transmission of infection (2) keeps the clients in the same room; should not be done (3) puts them in separate rooms but same nurse is caring for them (4) correct-to prevent spread of infection, clients should have private rooms with different nurses
The nurse is caring for a client with a history of rheumatoid arthritis who is receiving prednisone 10 mg PO daily. Which of the following symptoms should the nurse report immediately?
- A. Mild fatigue.
- B. Weight gain of 5 pounds in a month.
- C. Occasional joint stiffness.
- D. Mild headache.
Correct Answer: B
Rationale: Weight gain of 5 pounds in a month suggests prednisone-induced fluid retention, requiring evaluation. Options A, C, and D are less urgent.