Nokea
The nurse has attended a staff education program about medication administration during pregnancy. Which of the following medications should the nurse recognize are contraindicated during pregnancy? Select all that apply.
- A. lisinopril
- B. albuterol
- C. isotretinoin
- D. doxycycline
- E. levothyroxine
Correct Answer: A,C,D
Rationale: Lisinopril (teratogenic), isotretinoin (severe birth defects), and doxycycline (fetal bone/teeth damage) are contraindicated. Albuterol and levothyroxine are generally safe.
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The nurse is checking the client's central venous pressure. The nurse should place the zero of the manometer at the:
- A. Phlebostatic axis
- B. Point of maximum impulse (PMI)
- C. Erb's point
- D. Tail of Spence
Correct Answer: A
Rationale: The phlebostatic axis is the reference point for accurate central venous pressure measurement, as it corresponds to the right atrium's level. The point of maximum impulse, Erb's point, and Tail of Spence are not used for this purpose, so answers B, C, and D are incorrect.
The nurse is caring for 4 clients. Which client should the nurse see first?
- A. 2 days post abdominal aortic aneurysm repair with weak pedal pulses and mottled skin on the legs
- B. 2 days post coronary bypass graft surgery with a white blood cell count of 16,000/mm³ (16.0 × 10â¹/L)
- C. Chronic heart failure with peripheral edema and shortness of breath on exertion
- D. Pneumothorax with a chest tube to negative suction and subcutaneous emphysema
Correct Answer: A
Rationale: Weak pulses and mottled skin suggest vascular compromise, a life-threatening complication requiring immediate attention. The other conditions are less urgent.
Which of the following meals provides the lowest amount of potassium?
- A. Orange, cream of wheat, bacon
- B. Toast, jelly, soft boiled egg
- C. Raisin bran, milk, grapefruit
- D. Melon, pancakes, milk
Correct Answer: B
Rationale: Toast, jelly, and soft-boiled egg are low in potassium compared to fruits like oranges, grapefruit, or melon, which are high in potassium.
A client 4 days post colostomy is preparing to be discharged home. Which findings are concerning and should be further investigated? Select all that apply.
- A. Client states, 'I will need home health to empty the pouch.'
- B. Client states, 'There is a little gas in the colostomy bag.'
- C. No bowel sounds are present and the client reports nausea
- D. Skin surrounding the stoma is red and excoriated
- E. Stoma is red, edematous, and smaller than the previous day
Correct Answer: C,D,E
Rationale: Absent bowel sounds with nausea suggest obstruction, red/excoriated skin indicates irritation, and a shrinking stoma may signal complications. Gas is normal, and needing home health is not inherently concerning.
A client in the medical-surgical unit has an indwelling urinary catheter. Which actions should the nurse implement to reduce the incidence of catheter-associated urinary tract infections? Select all that apply.
- A. Cleanse periurethral area with antiseptics every shift
- B. Ensure each client has a separate container to empty collection bag
- C. Keep catheter bag below the level of the bladder
- D. Routinely irrigate the catheter with antimicrobial solution
- E. Use sterile technique when collecting a urine specimen
Correct Answer: B,C,E
Rationale: Using a separate container prevents cross-contamination. Keeping the bag below the bladder prevents urine backflow, reducing infection risk. E: Sterile technique minimizes pathogen introduction during specimen collection. A is incorrect as routine antiseptic cleansing can disrupt natural flora, increasing infection risk. D is incorrect as routine irrigation is not recommended unless medically indicated, as it can introduce pathogens.