Nokea
The nurse has received a prescription for celecoxib. Which finding in the client's medical history should prompt the nurse to question the administration of this medication?
- A. osteoarthritis
- B. gout
- C. recent myocardial infarction
- D. migraine headaches
Correct Answer: C
Rationale: Celecoxib, a COX-2 inhibitor, is contraindicated in clients with recent myocardial infarction due to increased cardiovascular risk.
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Which of the following interventions should the nurse include in the client's plan of care to prevent complications associated with TPN administered through a central line?
- A. Use a clean technique for all dressing changes.
- B. Tape all connections of the system.
- C. Encourage bed rest.
- D. Cover the insertion site with a moisture-proof dressing.
Correct Answer: B,D
Rationale: To prevent complications with TPN via a central line, taping all connections (B) prevents dislodgement, and a moisture-proof dressing (D) reduces infection risk. Clean technique (A) is insufficient; sterile technique is required. Bed rest (C) is not necessary and may increase complications like thrombosis. CN: Pharmacological and parenteral therapies; CL: Create
A 58-year-old male is going to have chemotherapy for lung cancer. He asks the nurse how the chemotherapeutic drugs will work. The most accurate explanation the nurse can give is which of the following?
- A. Immunotherapy affects all rapidly dividing cells.
- B. The molecular structure of the DNA is altered.
- C. Cancer cells are susceptible to drug toxins.
- D. Chemotherapy encourages cancer cells to divide.
Correct Answer: B
Rationale: Chemotherapy often works by altering the DNA structure of cancer cells, inhibiting their ability to replicate and leading to cell death.
For a client with rib fractures and a pneumothorax, the physician prescribes morphine sulfate, 1 to 2 mg/hour, given I.V. as needed for pain. The nursing care goal is to provide adequate pain control so that the client can breathe effectively. Which of the following outcomes would indicate successful achievement of this goal?
- A. Pain rating of 0 on a scale of 0 to 10 by the client.
- B. Respiratory rate of 26 breaths/minute.
- C. PaO2 of 70 mm Hg.
- D. None of the above
Correct Answer: A
Rationale: A pain rating of 0 indicates adequate pain control, enabling effective breathing. A respiratory rate of 26 is elevated, and a PaO2 of 70 mm Hg suggests mild hypoxemia, neither confirming pain control.
The nurse is assessing a client with heart failure who is receiving home health care monitoring using electronic devices including scales, blood pressure monitoring, and structured questions to which the client responds daily on a touch-screen monitor. The nurse reviews data obtained within the last 3 days. The nurse calls the client to follow up. The nurse should ask the client which of the following first:
- A. How are you feeling today?'
- B. Are you having shortness of breath?'
- C. Did you calibrate the scales before using them?'
- D. How much fluid did you drink during the last 24 hours?'
Correct Answer: B
Rationale: A 5-lb weight gain in 3 days and rising blood pressure suggest fluid retention. Asking about shortness of breath first assesses for pulmonary edema, a serious complication.
In developing a teaching plan for the client with a hiatal hernia, the nurse's assessment of which work-related factors would be most useful?
- A. Number and length of breaks.
- B. Body mechanics used in lifting.
- C. Temperature in the work area.
- D. Cleaning solvents used.
Correct Answer: B
Rationale: Poor body mechanics during lifting can increase intra-abdominal pressure, exacerbating hiatal hernia symptoms, making this the most relevant work-related factor.