Nokea
The nurse is caring for a 34-year-old man admitted with low back pain. The history indicates that the patient has hemophilia A. The nurse should question which of the following orders?
- A. Ketorolac tromethamine (Toradol).
- B. Codeine phosphate (Paveral).
- C. Oxycodone terephthalate (Percodan).
- D. Hydromorphone hydrochloride (Dilaudid).
Correct Answer: C
Rationale: contraindicated for persons with bleeding disorders, contains aspirin
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A brace is ordered for a young teen with scoliosis. The nurse knows that teaching has been effective if the client makes which of the following statements?
- A. I will have my parents put bed-boards on my bed.
- B. I should decrease my caloric intake.
- C. I should only take tub baths.
- D. I can remove the brace for one hour a day.
Correct Answer: D
Rationale: should be worn at all times, except when bathing
The nurse is caring for a client who is receiving total parenteral nutrition (TPN). Which of the following laboratory values should the nurse monitor closely?
- A. Serum potassium.
- B. Hemoglobin A1c.
- C. Platelet count.
- D. Serum creatinine.
Correct Answer: A
Rationale: TPN can cause electrolyte imbalances, particularly hyperkalemia or hypokalemia
The home care nurse instructs the wife of a client about how to perform a wet-to-dry abdominal dressing for her husband with an infected abdominal incision. The nurse should intervene in which of the following situations?
- A. The wife wets the old dressing with sterile saline before removing it.
- B. The wife covers the wound with wet, sterile 4 × 4s.
- C. The wife irrigates the wound with hydrogen peroxide using a bulb syringe.
- D. The wife uses Montgomery straps to secure the dressing.
Correct Answer: A
Rationale: contraindicated, remove dry so wound debris and necrotic tissue are removed with old dressing
The nurse is caring for a patient who experienced a thermal injury two weeks ago. The nurse would be MOST concerned if which of the following is observed?
- A. Increased heart rate and elevated blood pressure.
- B. Temperature of 100.6°F (38.1°C) and decreased respiratory rate.
- C. Increased heart rate and decreased respiratory rate.
- D. Increased respiratory rate and decreased blood pressure.
Correct Answer: D
Rationale: may indicate burn wound sepsis, a life-threatening complication of thermal injury
A college student was in a motor vehicle accident six months ago. Although he was minimally injured, his friend was killed. The client comes to Student Health Services with complaints of not being able to study, not sleeping, and thinking he's 'going crazy.'
It is MOST important for the nurse to
- A. perform a complete physical and social history.
- B. obtain a complete drug and alcohol history, including reports from a drug screen.
- C. review the significant events of the last year.
- D. explore how he coped with the motor vehicle crash and his friend's death.
Correct Answer: D
Rationale: Strategy: Determine the outcome of each answer choice. (1) not most important initially (2) not most important initially (3) not most important initially (4) correct-initially obtaining focused information about a very traumatic event is helpful and provides the nurse with an opportunity to understand how this client has coped with a tragedy that has made him vulnerable