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The client who has renal cancer that has metastasized rates pain at a 9 on a 0 to 10 pain scale. Which medication should the nurse plan to administer now and then schedule to be administered at the prescribed dosing interval?
- A. Meperidine
- B. Propoxyphene
- C. Pentazocine
- D. Oxycodone
Correct Answer: D
Rationale: A. Meperidine (Demerol) is not recommended because it causes CNS toxicity from metabolites. It should not be used for the treatment of chronic pain. B. Propoxyphene
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The client has undergone a lymph node biopsy to differentiate between Hodgkin’s and non-Hodgkin’s lymphoma. After reviewing the client’s lymph node biopsy results, which revealed that the client has Hodgkin’s lymphoma, the nurse should obtain which educational brochure?
- A. The brochure that includes an explanation of an elevated reticulocyte count
- B. The brochure that includes an explanation of CA-125 tumor markers
- C. The brochure that includes an explanation of an elevated WBC count
- D. The brochure that includes an explanation about Reed-Sternberg cells
Correct Answer: D
Rationale: A. Reticulocytes are found in a CBC, not from a lymph node biopsy, and are not indicative of either Hodgkin’s or non-Hodgkin’s lymphoma. B. CA-125 tumor markers are sometimes used in the management of ovarian cancer. C. WBCs are collected from a complete blood panel, not a lymph node biopsy, and could be indicative of other lymphomas and/or leukemia. D. The nurse should obtain the brochure that explains about Reed-Sternberg cells. The main diagnostic feature of Hodgkin’s lymphoma is the presence of Reed-Sternberg cells in a lymph node biopsy.
The nurse administers iron using the Z track technique. What is the primary reason for administering iron via Z track?
- A. To prevent adverse reactions
- B. To prevent staining of the skin
- C. To improve the absorption rate
- D. To increase the speed of onset of action
Correct Answer: B
Rationale: The Z track technique prevents iron from leaking into subcutaneous tissue, reducing skin staining.
The client diagnosed with sickle cell anemia comes to the emergency department complaining of joint pain throughout the body. The oral temperature is 102.4°F and the pulse oximeter reading is 91%. Which action should the emergency department nurse implement first?
- A. Request arterial blood gases STAT.
- B. Administer oxygen via nasal cannula.
- C. Start an IV with an 18-gauge angiocath.
- D. Prepare to administer analgesics as ordered.
Correct Answer: B
Rationale: SpO2 91% and fever suggest hypoxia in SCA crisis; oxygen via cannula (B) addresses this first. ABGs (A), IV (C), and analgesics (D) follow to confirm hypoxia, hydrate, and manage pain.
The client with hemophilia A is experiencing hemarthrosis. Which intervention should the nurse recommend to the client?
- A. Alternate aspirin and acetaminophen to help with the pain.
- B. Apply cold packs for 24 to 48 hours to the affected area.
- C. Perform active range-of-motion exercise on the extremity.
- D. Put the affected extremity in the dependent position.
Correct Answer: B
Rationale: Hemarthrosis requires cold packs (B) to reduce bleeding/swelling. Aspirin (A) increases bleeding, ROM (C) worsens damage, and dependent position (D) increases swelling.
The nurse has been teaching the parents of a child with hemophilia about the care he will need. Which statement by the parents indicates a need for more instruction?
- A. If my child needs something for pain or a fever, I will give him acetaminophen instead of aspirin.'
- B. I will take my child to the dentist for regular checkups.'
- C. I will keep my child in the house most of the time.'
- D. My son's Medic Alert Bracelet arrived.'
Correct Answer: C
Rationale: Overprotecting the child by keeping him indoors most of the time prevents normal development. Acetaminophen, dental care, and a Medic Alert bracelet are appropriate.