Nokea
The client has an order for gentamycin to be administered. Which lab results should be reported to the doctor before beginning the medication?
- A. Hematocrit
- B. Creatinine
- C. White blood cell count
- D. Erythrocyte count
Correct Answer: B
Rationale: Creatinine levels indicate renal function, critical to monitor before administering gentamycin, which is nephrotoxic.
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The nurse is completing the preoperative checklist on a client scheduled for surgery and finds that the consent form has been signed, but the client is unclear about the surgery and possible complications. Which is the most appropriate action?
- A. Call the surgeon and ask him to come see the client to clarify the information
- B. Explain the procedure and complications to the client
- C. Check in the physician's progress notes to see if understanding has been documented
- D. Check with the client's family to see if they understand the procedure fully
Correct Answer: A
Rationale: Informed consent requires that the client understands the procedure and its risks. If the client is unclear, the surgeon, as the primary provider, should clarify the information to ensure the client's understanding, as this is a legal and ethical requirement.
A 52-year-old female with mitral valve stenosis is admitted to the floor. She asks the nurse why she got this condition because it does not run in her family. The nurse explains most cases of mitral stenosis are due to a history of
- A. right-sided heart failure.
- B. hypercholesterolemia.
- C. rheumatic fever.
- D. viral meningitis.
Correct Answer: C
Rationale: Rheumatic fever is the primary cause of mitral valve stenosis, leading to valve scarring years later.
Which finding is associated with Tay Sachs disease?
- A. Pallor of the conjunctiva
- B. Cherry-red spots on the macula
- C. Blue-tinged sclera
- D. White flecks in the iris
Correct Answer: B
Rationale: Cherry-red spots on the macula are a classic finding in Tay-Sachs disease due to lipid accumulation in retinal ganglion cells.
A client with alcoholism has been instructed to increase his intake of thiamine. The nurse knows the client understands the instructions when he selects which food?
- A. Roast beef
- B. Broiled fish
- C. Baked chicken
- D. Sliced pork
Correct Answer: D
Rationale: Sliced pork is a rich source of thiamine (vitamin B1), which is critical for preventing Wernicke's encephalopathy in clients with alcoholism.
A client with Addison's disease has been receiving glucocorticoid therapy. Which finding indicates a need for dosage adjustment?
- A. Dryness of the skin and mucus membranes
- B. Dizziness when rising to a standing position
- C. A weight gain of 6 pounds in the past week
- D. Difficulty in remaining asleep
Correct Answer: C
Rationale: A weight gain of 6 pounds in a week suggests fluid retention, indicating possible overdosage of glucocorticoids, requiring adjustment.