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The client with rheumatoid arthritis tells the nurse, 'I have a friend who took gold shots and had a wonderful response. Why didn't my physician let me try that?' Which of the following responses by the nurse would be most appropriate?
- A. It's the physician's prerogative to decide how to treat you. The physician has chosen what is best for your situation.'
- B. Tell me more about your friend's arthritic condition. Maybe I can answer that question for you.'
- C. That drug is used for cases that are worse than yours. It wouldn't help you, so don't worry about it.'
- D. Every person is different. What works for one client may not always be effective for another.'
Correct Answer: D
Rationale: Individual responses to treatments vary due to differences in disease severity, comorbidities, and side effect profiles. This response educates the client without dismissing their concerns.
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The following scenario applies to the next 1 items
The nurse has received prescriptions for a newborn infant in the postpartum unit.
Item 1 of 1
Orders
1958:
• phytonadione 1 mg intramuscular (IM) x 1 dose
• erythromycin ophthalmic ointment 0.5% apply from unit dose (1 cm) to both eyes
The nurse administers the prescribed medications.
The nurse should administer the phytonadione using ............ The nurse will inject the medication.............................It would be appropriate for the nurse to ...................... The nurse understands that the purpose of administering newborn erythromycin ophthalmic ointment is ............................. The nurse should apply this ointment to the ......................... Once the ointment is administered, the nurse should ..........................
- A. ¾-in, 25-gauge needle.
- B. into the middle third of the anterolateral aspect of the thigh.
- C. aspirate before injecting the medication.
- D. massage the area to promote medication absorption.
- E. prevent ophthalmia neonatorum caused by Neisseria gonorrhoeae.
- F. lower conjunctival sac.
- G. wipe the ointment from the outer eye after one minute.
Correct Answer: A,B,D,E,F
Rationale: Phytonadione is administered with a 25-gauge, ¾-in needle in the vastus lateralis; erythromycin prevents ophthalmia neonatorum and is applied to the lower conjunctival sac without wiping.
Which of the following client statements identifies a knowledge deficit about cast care?
- A. I'll elevate the cast above my heart initially.'
- B. I'll exercise my joints above and below the cast.'
- C. I can pull out cast padding to scratch inside the cast.'
- D. I'll apply ice for 10 minutes to control edema for the first 24 hours.'
Correct Answer: C
Rationale: Pulling out cast padding can cause skin irritation or pressure sores, indicating a knowledge deficit.
The client's family asks why the client who had a splenectomy has a nasogastric (NG) tube. An NG tube is used to:
- A. Move the stomach away from where the spleen was removed.
- B. Irrigate the operative site.
- C. Decrease abdominal distention.
- D. Assess for the gastric pH as peristalsis returns.
Correct Answer: C
Rationale: An NG tube is used post-splenectomy to decompress the stomach and decrease abdominal distention, which can reduce pressure on the surgical site and promote healing. It does not move the stomach, irrigate the site, or assess gastric pH.
Which of the following interventions should the nurse include in the client's plan of care to prevent complications associated with TPN administered through a central line?
- A. Use a clean technique for all dressing changes.
- B. Tape all connections of the system.
- C. Encourage bed rest.
- D. Cover the insertion site with a moisture-proof dressing.
Correct Answer: B,D
Rationale: To prevent complications with TPN via a central line, taping all connections (B) prevents dislodgement, and a moisture-proof dressing (D) reduces infection risk. Clean technique (A) is insufficient; sterile technique is required. Bed rest (C) is not necessary and may increase complications like thrombosis. CN: Pharmacological and parenteral therapies; CL: Create
A client had a colectomy 8½ hours ago. She has received 1,500 mL of dextrose 5% in water with normal saline solution. The client has just used a patient-controlled analgesia pump to administer morphine for pain, has been repositioned for comfort, and has stable pulse rate, respirations, and blood pressure. What should the nurse do next?
- A. Check that the family is comfortable.
- B. Assess vital signs following the use of morphine.
- C. Dim the lights in the room.
- D. Increase nasal oxygen from 2 to 3 L.
Correct Answer: B
Rationale: Morphine can cause respiratory depression or hypotension. Assessing vital signs after PCA use ensures the client's safety and detects adverse effects promptly.