Nokea
The clinic nurse is teaching a co-worker regarding medication administration. The nurse is aware that which of the following medications are category X medications and should not be taken by the client during pregnancy?
- A. Menocycline
- B. Tazorac
- C. Devonex
- D. Levothyroxine
- E. Cefozolin
Correct Answer: A, B
Rationale: Category X medications, like minocycline (A) and tazarotene (Tazorac, B), are contraindicated in pregnancy due to fetal harm. Calcipotriene (Devonex, C), levothyroxine (D), and cefazolin (E) are safer (categories B or C).
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A 71-year-old client fell and injured her left leg while cooking in the kitchen. Her husband calls the ambulance, and she is taken to the emergency department at a local hospital. X-ray reports confirm that she has an intertrochanteric fracture of the left femur. Her left leg will require skeletal traction initially and then surgery. The nurse knows that this type of traction will be used:
- A. By inserting pins to provide steady pull on the bone
- B. To suspend the leg in a sling without pull on the extremity
- C. Intermittently to place a pull over the pelvis and lower spine
- D. With weights at both ends of the bed to maintain pull on the upper extremity
Correct Answer: A
Rationale: Skeletal traction is the application of traction directly to bone with the use of pins and wires or tongs for the purpose of providing a strong, steady, continuous longitudinal pull on the bone. It is indicated for preoperative immobilization and positioning of hip and femur fractures. A type of skeletal traction (balanced suspension with a Thomas splint and Pearson attachment) uses a sling to support the extremity, but it also uses weights to provide a strong, steady continuous pull on the extremity. A sling is used instead of pins. Pelvic traction provides an intermittent pull over the pelvis and bone, whereas skeletal traction is continuous. Pelvic traction does not use pins. Skeletal traction uses weights at the end of the bed to provide a continuous pull on long bones. Weights are not applied to both ends of the bed.
The nurse is caring for a client with a history of peripheral artery disease. The nurse should expect the client to have:
- A. Intermittent claudication
- B. Edema in the extremities
- C. Warm extremities
- D. Hyperpigmentation
Correct Answer: A
Rationale: Peripheral artery disease reduces blood flow, causing intermittent claudication (leg pain with activity) due to muscle ischemia.
A primigravida with a blood type A negative is at 28 weeks' gestation. Today her physician has ordered a RhoGAM injection. Which statement by the client demonstrates that more teaching is needed related to this therapy?
- A. I'm getting this shot so that my baby won't develop antibodies against my blood, right?'
- B. I understand that if my baby is Rh positive I'll be getting another one of these injections.'
- C. This shot should help to protect me in future pregnancies if this baby is Rh positive, like my husband.'
- D. This shot will prevent me from becoming sensitized to Rh-positive blood.'
Correct Answer: A
Rationale: RhoGAM is given to Rh-negative mothers to prevent the maternal Rh immune response to fetal Rh-positive antigens. If the infant is Rh positive, the mother will receive another dose postdelivery to prevent maternal sensitization. Prevention of maternal sensitization will protect future pregnancies because the mother's blood will be free of antibodies against her fetus. RhoGAM prevents maternal sensitization to Rh-positive blood.
Often children are monitored with pulse oximeter. The pulse oximeter measures the:
- A. O2 content of the blood
- B. Oxygen saturation of arterial blood
- C. PO2
- D. Affinity of hemoglobin for O2
Correct Answer: B
Rationale: The O2 content of whole blood is determined by the partial pressure of oxygen (PO2) and the oxygen saturation. The pulse oximeter does not measure the PO2. The pulse oximeter is a noninvasive method of measuring the arterial oxygen saturation. The PO2 is the amount of O2 dissolved in plasma, which the pulse oximeter does not measure. The affinity of hemoglobin for O2 is the relationship between oxygen saturation and PO2 and is not measured by the pulse oximeter.
The nurse is caring for a client with a history of peptic ulcer disease. Which food should the client avoid?
- A. Spicy foods
- B. Apples
- C. Rice
- D. Milk
Correct Answer: A
Rationale: Spicy foods can irritate the gastric mucosa, exacerbating peptic ulcer disease. Apples, rice, and milk (in moderation) are generally safe.