Nokea
The best lab test to diagnose disseminated intravascular coagulation (DIC) is:
- A. platelet count
- B. protime (PT)
- C. partial thromboplastin time (PTT)
- D. D-dimer
Correct Answer: D
Rationale: The D-dimer test specifically detects fibrin degradation products, indicating DIC's characteristic clotting and fibrinolysis. Other tests are less specific.
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The 6-month-old hospitalized with dehydration is being rehydrated with IV fluids. Which findings should indicate to the nurse that the treatment is having the desired effect? Select all that apply.
- A. Flat fontanelle
- B. Absence of crying
- C. Light yellow urine
- D. Rapid respirations
- E. Moist mucous membranes
Correct Answer: A,C,E
Rationale: A: Flat (rather than depressed) fontanelles indicate good hydration, which is the desired effect of IV rehydration. B: Absence of crying is not related to improved hydration status. C: Light-colored urine indicates good hydration, which is the desired effect of IV rehydration. D: Rapid respirations may indicate dehydration. E: Moist mucous membranes indicate good hydration, which is the desired effect of IV rehydration.
The nurse teaches the client with relapsing-remitting MS about glatiramer. Which information addressed by the client indicates that the nurse's teaching has been effective? Select all that apply.
- A. Keep the medication vial refrigerated until it is to be used.
- B. Glatiramer is given by injection into the subcutaneous tissue.
- C. Rotate injection sites and wait a week before using a site again.
- D. The thigh and abdomen are the best subcutaneous injection sites.
- E. Syringes are washed, air dried, and reused until the needle is dull.
Correct Answer: A,B,C
Rationale: A: Glatiramer is used to delay the progression of MS. To maximize the therapeutic effects of glatiramer, it should be refrigerated and reconstituted correctly. B: Glatiramer is only administered subcutaneously; accidental IV administration must be avoided. C: Injection sites are rotated to prevent skin breakdown or lumps at the injection sites. D: Appropriate subcutaneous injection sites for glatiramer include the thigh, back of the hip, abdomen, and upper arm. E: Used syringes should be placed in a puncture-resistant container for proper disposal. Syringes and needles should not be reused.
The nurse telephones the HCP to request a pm anxiolytic medication order for a hospitalized client having occasional anxiety. Which medication, if prescribed, should the nurse question regarding its effectiveness for prn use?
- A. Buspirone
- B. Lorazepam
- C. Clorazepate
- D. Clonazepam
Correct Answer: A
Rationale: Buspirone (BuSpar) has a 10- to 14-day delay in therapeutic onset, making it unsuitable for prn use.
A 37-year-old female client asks the nurse about contraception options, and says she would like to ask her doctor for a prescription for an oral contraception pill. Which of the following statements would indicate that oral contraception is appropriate for this client?
- A. I quit smoking last year, but I started again recently. Maybe I'll try to quit later this year.
- B. I am very diligent at taking my thyroid medications at the same time every day.
- C. I was hospitalized for deep vein thrombosis five years ago.
- D. I was recently diagnosed with breast cancer.
Correct Answer: B
Rationale: The client's statement about medication diligence shows that this client could be compliant with a daily oral contraceptive. Contraindications to oral contraception include breast cancer, a history of deep vein thrombosis, and smoking if over age 35.
An LPN is reviewing medication lists for several clients recently admitted to the hospital. Which of the following scenarios would be least concerning?
- A. A client taking allopurinol for gout states they have been taking black cohosh to help with post-menopausal symptoms.
- B. A client has an order for warfarin and states they have been taking Ginkgo biloba to improve their memory.
- C. A client taking Lipitor states they have been taking ginseng for an energy boost.
- D. A client has a prescription for an SSRI and states they have been taking St. John's wort to also help with their depression.
Correct Answer: C
Rationale: Ginseng may cause an increased risk of bleeding but should not interact with Lipitor. St. John's wort should not be taken with an SSRI as it may cause serotonin syndrome. Black cohosh should not be taken with allopurinol as they can both cause hepatotoxicity, especially in combination. Ginkgo biloba should not be taken with warfarin as it causes an increased risk of bleeding.