Nokea
The intravenous route is potentially the most dangerous route of drug administration because:
- A. the IV might infiltrate.
- B. it is expensive and nursing intensive.
- C. rapid administration of a drug can lead to toxicity.
- D. the client always has more side effects.
Correct Answer: C
Rationale: The bioavailability of the injected medication is 100% and might lead to toxicity. An IV infiltration can cause serious problems with tissue necrosis, but this is not life threatening. Expensive and time consuming do not equate with dangerous. Not all clients experience more side effects with IV administration.
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After reviewing the child's immunization record, which scheduled vaccine should the nurse prepare to administer next?
- A. Hib
- B. IPV
- C. MMR
- D. DTaP
Correct Answer: D
Rationale: The correct answer is DTaP. DTaP is administered at 2, 4, and 6 months of age; between 15 and 18 months of age; and between 4 and 6 years of age. Since the child has only received three doses of this vaccine, the next dose of DTaP should be administered. The other options are incorrect because Hib is administered at 2, 4, and 6 months of age and between 12 and 15 months; IPV is administered at 2, 4, and 6 months of age and between 4 and 6 years of age; MMR is administered between 12 and 15 months of age and again between 4 and 6 years of age.
A client in labor complains of back discomfort. Which position will best aid in relieving the discomfort? What position should the nurse encourage the mother to assume?
- A. Prone
- B. Standing
- C. Supine
- D. Hands and knees
Correct Answer: D
Rationale: During back labor, when the back of the fetal head puts pressure on the woman's sacral promontory, the hands-and-knees position is encouraged. This position helps the fetus move away from the sacral promontory, reducing back pain and enhancing the internal-rotation mechanism of labor. A prone position would be difficult for the woman to assume and not helpful in relieving back discomfort. The supine position is risky due to supine hypotension, while standing may increase pressure, worsening backache.
A pregnant client is scheduled to undergo a transabdominal ultrasound, and the nurse provides information to the client about the procedure. The nurse provides which information?
- A. The procedure typically takes 10 to 30 minutes.
- B. She may need to drink fluids before the test and may not void until the test has been completed.
- C. A probe coated with gel will be inserted into the vagina.
- D. She will be positioned on her back, with her head elevated and turned slightly to one side.
Correct Answer: B
Rationale: The correct answer is that the client may need to drink fluids before the test and may not void until the test has been completed. For a transabdominal ultrasound, the woman is positioned on her back with her head elevated and turned slightly to one side to prevent supine hypotension. A wedge or rolled blanket is placed under one hip to help her maintain this position comfortably. If a full bladder is necessary, the woman is instructed to drink several glasses of clear fluid 1 hour before the test and told that she should not void until the test has been completed. Warm mineral oil or transmission gel is spread over her abdomen, and the sonographer slowly moves a transducer over the abdomen to obtain a picture. The procedure typically takes 10 to 30 minutes, making choice A incorrect. Choice C is incorrect because a probe is not inserted into the vagina for a transabdominal ultrasound. Choice D is incorrect because the woman is positioned on her back with her head elevated and turned slightly to one side, not specifically on her back.
Distribution of a drug to various tissues is dependent on the amount of cardiac output to each type of tissue. Which tissue would receive the highest amount of cardiac output and thus the highest amount of a drug?
- A. skin
- B. adipose tissue
- C. skeletal muscle
- D. myocardium
Correct Answer: D
Rationale: Highly perfused tissue includes all vital organs: the brain, heart, kidneys, adrenal glands, and liver. Choices 1, 2, and 3 are incorrect because the skin and adipose tissue are poorly perfused, while the skeletal muscle is better perfused.
A client describes her cervical mucus as clear, thin, and elastic. Upon examination, the nurse demonstrates that the cervical mucus can be stretched 8-10 cm. The nurse correctly documents the finding as:
- A. Ferning capacity
- B. Lack of ferning
- C. Spinnbarkheit
- D. Inhospitable
Correct Answer: C
Rationale: Spinnbarkheit is the term for stretchy, elastic cervical mucus at ovulation, indicating fertility. Ferning requires microscopic examination, and inhospitable mucus inhibits sperm motility.