Nokea
The nurse has received a prescription for a mannitol infusion. Which type of intravenous tubing should be used to administer mannitol?
- A. Microdrip
- B. Filtered
- C. Vented
- D. Non-vented
Correct Answer: B
Rationale: Mannitol is a hyperosmolar diuretic that can crystallize in IV tubing, potentially causing blockages. Filtered tubing is required to prevent crystals from entering the bloodstream, ensuring safe administration. Microdrip, vented, and non-vented tubing do not address this risk.
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The nurse is caring for an older adult with advanced dementia. The client asks about her deceased sister, 'When will my sister come to visit me this afternoon?' Which is the best response from the nurse?
- A. This is so sad. I'm sorry to tell you but your sister died last year.'
- B. She won't be coming to visit today.'
- C. I understand you want her to visit you. Where did you and your sister grow up?'
- D. Wait and see if she comes to visit today.'
Correct Answer: C
Rationale: Redirecting the conversation compassionately avoids distress and engages the client with dementia.
The following scenario applies to the next 1 items
The nurse in the clinic is caring for a 46-year-old female
Item 1 of 1
Nurses' Notes
0855: Client was brought to the clinic by her husband, who reports that she has been falling frequently, having difficulty remembering things, and numbness and tingling in the lower extremities. Onset was 2 weeks ago, with the falling and memory impairment worsening over the past week. The client was hospitalized 3 weeks ago because she ran out of medication, and her atrial fibrillation was giving her 'palpitations and shortness of breath.' Since refilling her medication, she has had no palpitations, chest discomfort, or dyspnea. The client's husband reports that he is worried about his wife's drinking because it has increased from three beers a day to five or six. She reports that her last drink was four days ago. On assessment, the client is alert and oriented to person, place, and time. Some speech latency was noted in her response. Her gait is unsteady, and had to be assisted to the examination room. Pupils are equal, round, and reactive to light with nystagmus. Skin is warm to touch and a normal color for ethnicity. Breathing is unlabored, and lung sounds are clear bilaterally. She reports occasional nonproductive cough. Bowel sounds present in all four quadrants. Peripheral pulses 2+ and irregular. Vital signs: T 97°F (36°C), P 72, RR 14, BP 136/78, pulse oximetry reading 97% on room air. Denies any pain, but reports tingling in her lower extremities.
Complete the diagram by dragging from the choices below to specify what condition the client is most likely experiencing, two (2) actions the nurse should take to address that condition, and two (2) parameters the nurse should monitor to assess the client's progress: Condition
- A. Start a peripheral vascular access device
- B. Wernicke encephalopathy
- C. Transient ischemic attack
- D. Alcohol withdrawal
- E. Obtain a prescription for thiamine
- F. Lower extremity paresthesias
- G. Gait
Correct Answer: A,B,E,F,G
Rationale: Wernicke encephalopathy is likely due to memory impairment, ataxia, and nystagmus in the context of alcohol use. Thiamine is critical for Wernicke encephalopathy, and IV access facilitates its administration. Monitoring gait and level of consciousness assesses improvement in Wernicke encephalopathy.
The emergency department (ED) nurse triages a client with suspected bacterial meningitis. The nurse plans on assessing the client for Kernig's sign. The nurse understands that this sign is positive when the client?
- A. Reports pain when the knee is extended and the hip flexed.
- B. Has a stiff neck when the neck is flexed towards the chest.
- C. Forearm spasms when a blood pressure cuff is inflated on the upper arm.
- D. Reports pain in the calf when the foot is dorsiflexed.
Correct Answer: A
Rationale: Kernig's sign is positive when hip flexion with knee extension causes pain, indicating meningitis.
The nurse is assessing a client taking prescribed lamotrigine. Which client finding requires immediate follow-up?
- A. Abnormal dreams
- B. Skin blistering
- C. Dyspepsia
- D. Xerostomia
Correct Answer: B
Rationale: Skin blistering is a serious adverse effect of lamotrigine, potentially indicating Stevens-Johnson syndrome or toxic epidermal necrolysis, both life-threatening conditions requiring immediate medical attention. Abnormal dreams, dyspepsia, and xerostomia are less severe side effects that do not typically require urgent follow-up.
The nurse is caring for a client diagnosed with Multiple Sclerosis (MS). The nurse should anticipate a prescription for which medication?
- A. Topiramate
- B. Risperidone
- C. Prazosin
- D. Baclofen
Correct Answer: D
Rationale: Baclofen is a muscle relaxant commonly prescribed for spasticity in Multiple Sclerosis. Topiramate is used for seizures or migraines, risperidone for psychiatric conditions, and prazosin for hypertension, none of which are primary treatments for MS.