Nokea
The nurse collecting data from the client is providing instructions regarding a new prescription for disulfiram. Which datum is important for the nurse to obtain before beginning the administration of this medication?
- A. When the last full meal was consumed
- B. When the last alcoholic drink was consumed
- C. If the client has a history of hyperthyroidism
- D. If the client has a history of diabetes insipidus
Correct Answer: B
Rationale: Disulfiram may be used as an adjunct treatment for selected clients with chronic alcoholism who want to remain in a state of enforced sobriety. Clients must abstain from alcohol intake for at least 12 hours before the initial dose of the medication is administered. Therefore, it is important for the nurse to determine when the last alcoholic drink was consumed. The medication is used with caution in clients with diabetes mellitus, hypothyroidism, epilepsy, cerebral damage, nephritis, and hepatic disease. It is also contraindicated in severe heart disease, psychosis, or hypersensitivity related to the medication.
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A mother who is visibly upset tells the nurse she wants to take her child home because the child is dying. Which of the following would be the nurse's best response?
- A. I know how you feel, but the medication will make your child feel better.'
- B. I can't let you do this without calling your physician first.'
- C. Can you tell me why you want to take your child home now?'
- D. I can imagine how hard this is for you, but it's not what's best for the child.'
Correct Answer: C
Rationale: Asking the mother to explain her reasons encourages open communication and helps the nurse understand her concerns, facilitating appropriate support or intervention.
A nurse is instructing a client about the use of nitroglycerin patches. The nurse should instruct the client to:
- A. Remove the patch every night.
- B. Apply the patch only when chest pain occurs.
- C. Change the site of the patch every day.
- D. Apply the patch only on alternate days.
Correct Answer: A,C
Rationale: Nitroglycerin patches require a daily nitrate-free interval (typically at night) to prevent tolerance, and the site should be rotated daily to avoid skin irritation.
Which of the following security concerns is also a sentinel event that must be reported?
- A. A possible vulnerability of the facility's information technology to hacking
- B. The assisted suicide of a client in your facility by the spouse of the client
- C. Vulnerability to computer hacking
- D. Potential information theft
Correct Answer: B
Rationale: The assisted suicide of a client is a sentinel event, as it is an unexpected occurrence involving death, requiring immediate investigation and reporting per The Joint Commission standards.
You are caring for a client who has just had a thoracentesis. Which complication should you be aware of during the immediate post-operative period of time?
- A. Infection
- B. Pneumothorax
- C. Aspiration
- D. Dyspnea
Correct Answer: B
Rationale: Pneumothorax is a potential complication of thoracentesis due to the risk of lung puncture during the procedure, requiring immediate monitoring.
A client with a history of cirrhosis is admitted with ascites. Which dietary modification should the nurse recommend?
- A. Low-sodium diet
- B. High-protein diet
- C. Low-fat diet
- D. High-carbohydrate diet
Correct Answer: A
Rationale: A low-sodium diet reduces fluid retention in ascites, helping to manage symptoms in clients with cirrhosis.