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The HCP prescribes 5% albumin for four clients. The nurse should consult with the HCP if 5% albumin is prescribed for which client?
- A. The client of the Catholic faith who has refractory edema
- B. The African American client experiencing hypovolemic shock
- C. The client of the Jehovah's Witnesses faith who has cerebral edema
- D. The Asian client experiencing adult respiratory distress syndrome (ARDS)
Correct Answer: C
Rationale: A: Persons of the Catholic faith usually accept blood and blood products. B: Persons of African American ethnicity usually accept blood and blood products. C: Albumin is a blood derivative obtained by fractionating pooled venous and placental human plasma. Persons of the Jehovah's Witnesses faith usually do not accept RBCs; some do not accept blood products such as albumin or plasma. D: Persons of Asian ethnicity usually accept blood and blood products.
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The hospitalized client is prescribed to receive ferrous fumarate 200 mg oral daily. When transcribing the medication onto the client's MAR, at which time in military time should the nurse schedule the daily dose for best absorption?
- A. 830
- B. 1000
- C. 1230
- D. 1730
Correct Answer: B
Rationale: A: 0830 is near the time of breakfast in a health care facility. Food reduces the absorption of iron. B: For best absorption and therapeutic effectiveness, the nurse should schedule ferrous fumarate (Feosol) at 1000. Iron preparations should be administered one hour before or two hours after a meal because food diminishes iron absorption. C: 1230 is near lunchtime in a health care facility. Food reduces the absorption of iron. D: 1730 is near the evening meal in a health care facility. Food reduces the absorption of iron.
One of the major functions of the kidneys in maintaining normal fluid balance is:
- A. the manufacture of antidiuretic hormone.
- B. the regulation of calcium and phosphate balance.
- C. the regulation of the pH of the extracellular fluid.
- D. the control of aldosterone levels.
Correct Answer: C
Rationale: Major functions of the kidneys in maintaining normal fluid balance include regulation of extracellular fluid and osmolarity by selective retention and excretion of fluids, regulation of pH of the extracellular fluid by retention of hydrogen ions, and excretion of metabolic wastes and toxic substances. ADH is manufactured by the pituitary, and the parathyroid regulates calcium and phosphate balance.
The factor that most determines drug distribution is:
- A. vascular perfusion of the tissue or organ.
- B. salt form.
- C. drug interactions.
- D. steady state.
Correct Answer: A
Rationale: Drugs are distributed via the circulatory system. Adequate perfusion is necessary for distribution of a drug. The other choices are not as dependent on adequate perfusion.
Which of the following of Erikson's developmental stages are relevant to adults ages 18-64? Select all that apply.
- A. Ego Integrity vs. Despair
- B. Generativity vs. Stagnation
- C. Industry vs. Inferiority
- D. Initiative vs. Guilt
- E. Intimacy vs. Isolation
Correct Answer: A
Rationale: In the adult 18-64 stage, Intimacy vs. Isolation is relevant to young adulthood and Generativity vs. Stagnation is relevant to middle adulthood. Initiative vs. Guilt is relevant to preschool childhood. Industry vs. Inferiority is relevant to school-age childhood. Ego Integrity vs. Despair is relevant to mature adulthood after age 65.
The client taking imipramine is preparing for a summer vacation. Which information should the nurse include when planning client education regarding imipramine? Select all that apply.
- A. Drink additional fluids and add extra fiber to the diet
- B. Stop imipramine if experiencing any unpleasant side effects.
- C. Avoid alcohol, which can cause an additive depressant effect.
- D. Request an “as needed†sleeping pill in the event of insomnia.
- E. Wear sunglasses, protective clothing, and sunscreen while outdoors.
Correct Answer: A,C,E
Rationale: TCAs such as imipramine (Tofranil) may cause constipation, CNS depression when combined with alcohol, and photosensitivity. Increasing fluids and fiber, avoiding alcohol, and using sun protection are appropriate.