Nokea
The nurse is admitting a client with a diagnosis of severe malignant catatonia to the in-patient psychiatric unit. Under which condition would the nurse support the use of electroconvulsive therapy (ECT) as a first-line treatment?
- A. The client is in the first trimester of pregnancy.
- B. The client is gainfully employed.
- C. The client lives in an assisted living facility.
- D. The client is over 50 years of age.
Correct Answer: C
Rationale: ECT may be considered first-line for severe malignant catatonia in a controlled setting like an assisted living facility, where monitoring is feasible. Pregnancy and age are contraindications or require caution, and employment is irrelevant.
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A client with Lyme's disease is being treated with Achromycin (tetracycline HCl). The nurse should tell the client that the medication will be rendered ineffective if taken with:
- A. Antacids
- B. Salicylates
- C. Antihistamines
- D. Sedative-hypnotics
Correct Answer: A
Rationale: Antacids containing calcium, magnesium, or aluminum can bind tetracycline, reducing its absorption and effectiveness.
A new graduate nurse is assigned to a 30-year-old female requiring NG tube feeding. The preceptor reminds the graduate nurse to check placement of the NG tube before administering the feeding. The best way to do this is by
- A. verifying placement with an X-ray before each feeding.
- B. aspirating gastric contents and testing the contents on a pH paper.
- C. auscultating bowel sounds after administering a 30 cc air bolus.
- D. auscultating bowel sounds after administering the first 10 cc of tube feeding.
Correct Answer: B
Rationale: Aspirating gastric contents and checking pH (≤5.5 indicates gastric placement) is the most reliable bedside method to confirm NG tube placement.
The nurse is changing the ties of the client with a tracheotomy. The safest method of changing the tracheotomy ties is to:
- A. Apply the new tie before removing the old one.
- B. Have a helper present.
- C. Hold the tracheotomy with the nondominant hand while removing the old tie.
- D. Ask the doctor to suture the tracheostomy in place.
Correct Answer: A
Rationale: Applying the new tie before removing the old one ensures the tracheotomy tube remains secure, preventing accidental dislodgement.
A child with Tetralogy of Fallot is scheduled for a modified Blalock Taussig procedure. The nurse understands that the surgery will:
- A. Reverse the direction of the blood flow
- B. Allow better blood supply to the lungs
- C. Relieve pressure on the ventricles
- D. Prevent the need for further correction
Correct Answer: B
Rationale: The modified Blalock-Taussig procedure creates a shunt to improve pulmonary blood flow in Tetralogy of Fallot, enhancing lung oxygenation.
A community center is having a health fair. Which of the following main food courses should the nurse recommend as most healthful for a 20-year-old adult whose total cholesterol level is 300 mg/dL?
- A. fettuccine alfredo
- B. fried chicken
- C. grilled cheese sandwich with bacon
- D. natural peanut butter and banana sandwich on whole wheat bread
Correct Answer: D
Rationale: The peanut butter and banana sandwich on whole wheat bread is lower in saturated fats and healthier for managing high cholesterol.