Nokea
The client diagnosed with chronic obstructive pulmonary disease is being discharged and is prescribed the steroid prednisone. Which scientific rationale supports why the nurse instructs the client to taper off the medication?
- A. The pituitary gland must adjust to the decreasing dose.
- B. The beta cells of the pancreas have to start secreting insulin.
- C. This will allow the adrenal gland time to start functioning.
- D. The thyroid gland will have to start producing cortisol.
Correct Answer: C
Rationale: Prednisone suppresses adrenal cortisol production; tapering allows adrenal glands to resume function, preventing adrenal crisis.
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A woman is two months pregnant when her 5-year-old child develops rubella. What is most likely to be given to her?
- A. Immune serum globulin
- B. MMR
- C. RhoGam
- D. Rubella antitoxin
Correct Answer: A
Rationale: Immune serum globulin may be given to reduce the risk of rubella infection in the pregnant woman, protecting the fetus.
An 80 year-old client is admitted with a diagnosis of malnutrition. In addition to physical assessments, which of the following lab tests should be closely monitored?
- A. Urine protein
- B. Urine creatinine
- C. Serum calcium
- D. Serum albumin
Correct Answer: D
Rationale: Serum albumin. Serum albumin is a valuable indicator of protein deficiency and, later, nutritional status in adults. A normal reading for an elder's serum albumin is between 3.0-5.0 g/dl.
You are caring for a hypertensive client with a new order for captopril (Capoten). Which information should the nurse include in client teaching?
- A. Avoid green leafy vegetables
- B. Restrict fluids to 1000 cc/day
- C. Avoid the use of salt substitutes
- D. Take the medication with meals
Correct Answer: C
Rationale: Avoid the use of salt substitutes. Captopril can cause an accumulation of potassium or hyperkalemia. Clients should avoid the use of salt substitutes, which are generally potassium-based.
The client is showing ventricular ectopy, and the HCP orders amiodarone (Cordarone) intravenously. Which interventions should the nurse implement? Select all that apply.
- A. Monitor telemetry continuously.
- B. Assess the client's respiratory status.
- C. Evaluate the client's liver function studies.
- D. Confirm the original order with another nurse.
- E. Prepare to defibrillate the client at 200 joules.
Correct Answer: A,B,C
Rationale: Telemetry monitors dysrhythmias, respiratory status tracks amiodarone’s pulmonary toxicity risk, and liver studies monitor hepatotoxicity. Order confirmation is unnecessary, and defibrillation is unrelated.
The nurse is preparing to administer phenytoin (Dilantin), 100 mg intravenous push, to the client with a head injury who has an IV of D5W at 50 mL/hr. Which intervention should the nurse implement?
- A. Flush the IV tubing before and after with normal saline.
- B. Administer the medication if the Dilantin level is 22 mcg/mL.
- C. Push the Dilantin intravenously slowly over five (5) minutes.
- D. Expect the intravenous tubing to turn cloudy when infusing medication.
Correct Answer: A
Rationale: Phenytoin is incompatible with D5W; saline flush prevents precipitation. Level of 22 mcg/mL is toxic, slow push is correct but not primary, and cloudiness is avoidable.