Nokea
The client admitted with pneumonia is taking Imuran, an immunosuppressive agent. Which question should the nurse ask the client regarding this medication?
- A. Do you know this medication has to be tapered off when discontinued?
- B. Have you been exposed to viral hepatitis B or C recently?
- C. Why are you taking this medication, and how long have you taken it?
- D. Do you have a lot of allergies or sensitivities to different medications?
Correct Answer: C
Rationale: Imuran (azathioprine) use and duration clarify indication (e.g., autoimmune) and infection risk, critical with pneumonia. Tapering, hepatitis, or allergies are less immediate.
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An adult receives NPH insulin at 7:00 A.M. When is a hypoglycemic reaction most apt to develop?
- A. Mid morning
- B. Mid afternoon
- C. During the evening
- D. During the night
Correct Answer: B
Rationale: NPH insulin peaks 6-12 hours after administration (1:00 P.M.-7:00 P.M.), making mid-afternoon the likely time for hypoglycemia.
The nurse is administering a topical ointment to the client's rash on the right leg. Which intervention should the nurse implement first?
- A. Don nonsterile gloves.
- B. Cleanse the client's right leg.
- C. Check the client's armband.
- D. Wash the hands for 15 seconds.
Correct Answer: D
Rationale: Hand washing is the first step to prevent infection, per aseptic technique. Gloves, cleansing, or armband checks follow.
An adult client had an abdominal hysterectomy this morning. Meperidine HCl (Demerol) 75 mg IM q3-4h PRN for pain is ordered. At 9:00 P.M., she complains of lower abdominal pain. She was last medicated at 5:45 P.M. What is the most appropriate initial action for the nurse to take?
- A. Offer her a bed pan and a back rub
- B. Reposition her
- C. Administer meperidine HCl 75 mg IM
- D. Encourage her to perform relaxation and breathing exercises
Correct Answer: C
Rationale: The last dose was over 3 hours ago, within the PRN order. Administering meperidine is appropriate for pain relief.
The client diagnosed with diabetes insipidus is receiving vasopressin intranasally. Which assessment data indicate the medication is effective?
- A. The client reports being able to breathe through the nose.
- B. The client complains of being thirsty all the time.
- C. The client has a blood glucose of 99 mg/dL.
- D. The client is urinating every three (3) to four (4) hours.
Correct Answer: D
Rationale: Vasopressin reduces polyuria in diabetes insipidus; urination every 3–4 hours indicates effectiveness. Nasal breathing, thirst, or glucose are unrelated.
The nurse is caring for a client with schizophrenia who has been treated with quetiapine (Seroquel) for 1 month. Today the client is increasingly agitated and complains of muscle stiffness. Which of these findings should be reported to the health care provider?
- A. Elevated temperature and sweating
- B. Decreased pulse and blood pressure
- C. Mental confusion and general weakness
- D. Muscle spasms and seizures
Correct Answer: A
Rationale: Elevated temperature and sweating. Neuroleptic malignant syndrome (NMS) is a rare disorder that can occur as a side effect of antipsychotic medications. It is characterized by muscular rigidity, tachycardia, hyperthermia, sweating, altered consciousness, autonomic dysfunction, and increase in CPK. This is a life-threatening complication.