Nokea
The nurse is caring for a client after dental surgery. The dentist has prescribed ibuprofen (Motrin IB) 600 mg PO. The nurse would be MOST concerned if the client made which of the following statements?
- A. I was treated for a peptic ulcer two years ago.
- B. I had a transurethral resection of the prostate (TURP) last year.
- C. I attend Weight Watchers.
- D. I have been having problems with gout.
Correct Answer: A
Rationale: Ibuprofen risks gastroinTest inal bleeding in clients with a peptic ulcer history. Options B, C, and D are not contraindications.
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The nurse is preparing to care for a client who has returned to the surgical nursing unit following a radical neck dissection.
- A. What is the most appropriate nursing action for a client post-radical neck dissection with a tracheostomy?
- B. Suction the tracheostomy every four hours.
- C. Provide tracheostomy care every 12 hours.
- D. Assess the tracheostomy for patency every shift.
- E. Monitor the tracheostomy site for bleeding or swelling.
Correct Answer: D
Rationale: Following a radical neck dissection, monitoring the tracheostomy site for bleeding or swelling is critical due to the risk of hematoma or airway obstruction, which can be life-threatening. Suctioning and care are important but follow a schedule or as needed, and patency assessment is less urgent than monitoring for surgical complications.
Decentralized scheduling is used on a nursing unit. A chief advantage of this management strategy is that it:
- A. considers client and staff needs
- B. conserves time spent on planning
- C. frees the nurse manager to handle other priorities
- D. allows requests for special privileges
Correct Answer: A
Rationale: Decentralized staffing takes into consideration specific client needs and staff interests and abilities.
The nurse is teaching a client with a new diagnosis of type 2 diabetes about glipizide (Glucotrol). Which of the following statements by the client indicates a need for further teaching?
- A. I should take this medication 30 minutes before breakfast.
- B. I should avoid drinking alcohol while taking this medication.
- C. I should report sweating or shakiness to my doctor.
- D. I should stop this medication if my blood sugar is normal.
Correct Answer: D
Rationale: Stopping glipizide when blood sugar is normal is incorrect, as type 2 diabetes requires ongoing treatment to maintain control. Options A, B, and C are correct: pre-breakfast dosing maximizes efficacy, alcohol increases hypoglycemia risk, and sweating/shakiness indicate hypoglycemia.
The nurse is caring for a client with chronic obstructive pulmonary disease (COPD).
- A. Which intervention should the nurse include in the care plan for a client with COPD?
- B. Encourage a high-protein, low-carbohydrate diet.
- C. Administer oxygen at 6 liters per minute via nasal cannula.
- D. Teach the client to use pursed-lip breathing.
- E. Place the client in a supine position to promote rest.
Correct Answer: C
Rationale: Pursed-lip breathing prolongs exhalation, reducing air trapping and improving oxygenation in COPD. High-protein diets are beneficial but secondary, high-flow oxygen risks CO2 retention, and supine positioning impairs breathing.
The nurse is caring for a client with Rheumatoid Arthritis. Which nursing diagnosis should receive priority in the plan of care?
- A. Risk for injury
- B. Self care deficit
- C. Alteration in comfort
- D. Alteration in mobility
Correct Answer: C
Rationale: Alteration in comfort. Relieving pain is the number one objective of this client's plan of care.