Nokea
The client is prescribed levothyroxine (Synthroid) for hypothyroidism. Which instruction should the nurse include?
- A. Take the medication at bedtime.'
- B. Report palpitations or chest pain.'
- C. Increase dietary fiber to prevent constipation.'
- D. Take the medication with meals.'
Correct Answer: B
Rationale: Levothyroxine can cause cardiac side effects like palpitations or chest pain, which should be reported. It is taken in the morning, fiber is not directly related, and food reduces absorption.
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A client with a history of prostate cancer is admitted with complaints of bone pain. The nurse should give priority to:
- A. Monitoring for metastasis
- B. Administering pain medication
- C. Monitoring blood pressure
- D. Administering chemotherapy
Correct Answer: A
Rationale: Bone pain in prostate cancer often indicates bone metastasis, so monitoring for metastasis is the priority.
The nurse is caring for a client with a history of a fractured femur who is in a cast. The client complains of swelling. The nurse should:
- A. Apply ice to the cast
- B. Elevate the leg
- C. Massage the leg
- D. Notify the physician immediately
Correct Answer: B
Rationale: Elevating the leg reduces swelling in a casted femur by improving venous return. Ice is helpful, massage is contraindicated, and notification is needed if swelling persists.
Which behavior by a female client feeding her newborn demonstrates that she needs more teaching related to safety and infant feeding?
- A. She uses the bulb syringe to help clear her baby's nose when milk is regurgitated.
- B. She places her infant on her right side after feeding her.
- C. She props the bottle in the crib to feed her baby, which allows her to write birth announcements and feed her baby at the same time.
- D. She burps her baby by placing her in a sitting position, supporting her head and neck and gently massaging her back.
Correct Answer: C
Rationale: This practice is the proper use of the bulb syringe to clear the infant's airway in case of regurgitation. Placing the infant on either side or on the stomach prevents aspiration of regurgitated milk. 'Bottle propping' is an unsafe practice because it increases the likelihood of aspiration. This practice is one correct way of burping an infant.
A client hospitalized with cirrhosis has developed abdominal ascites. The nurse should provide the client with snacks that provide additional:
- A. Sodium
- B. Potassium
- C. Protein
- D. Fat
Correct Answer: C
Rationale: Ascites in cirrhosis is linked to hypoalbuminemia; increasing protein intake helps restore albumin levels, reducing fluid accumulation.
The client presents to the emergency room with a hyphema. Which action by the nurse would be appropriate?
- A. Elevate the head of the bed and apply ice to the eye.
- B. Place the client in a supine position and apply heat to the knee.
- C. Insert a Foley catheter and measure the intake and output.
- D. Perform a vaginal exam and check for a discharge.
Correct Answer: A
Rationale: A hyphema (blood in the anterior chamber of the eye) requires elevating the head to reduce intraocular pressure and applying ice to decrease swelling. The other actions are irrelevant to hyphema management.