Nokea
The nurse is caring for a client experiencing acute mountain sickness (AMS). The nurse anticipates a prescription for which medication?
- A. Sodium bicarbonate
- B. Acetazolamide
- C. Tamsulosin
- D. Dutasteride
Correct Answer: B
Rationale: Acetazolamide promotes acclimatization by inducing bicarbonate diuresis, alleviating AMS symptoms. Sodium bicarbonate (A) is used for acidosis, tamsulosin (C) for prostate issues, and dutasteride (D) for benign prostatic hyperplasia, none of which treat AMS.
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Which of the following is an expected outcome when a client is receiving an I.V. administration of furosemide?
- A. Increased blood pressure.
- B. Increased urine output.
- C. Decreased pain.
- D. Decreased premature ventricular contractions.
Correct Answer: B
Rationale: Furosemide, a loop diuretic, promotes diuresis, increasing urine output to reduce fluid overload in conditions like heart failure or post-MI.
The nurse observes the client instill eyedrops. The client says, 'I just try to hit the middle of my eyeball so the drops don't run out of my eye.' The nurse explains to the client that this method may cause:
- A. Corneal abrasion.
- B. Increased intraocular pressure.
- C. Systemic absorption of the medication.
- D. Ineffective distribution of the medication.
Correct Answer: A
Rationale: Instilling eyedrops directly onto the cornea (middle of the eyeball) can cause corneal abrasion due to the dropper tip or improper technique. Drops should be placed in the lower conjunctival sac.
A client with a history of heart failure has bilateral +4 edema of her right ankle that extends up to midcalf. She is sitting out of bed and has her legs in a dependent position. Which of the following goals is the priority?
- A. Decrease venous congestion
- B. Maintain normal respirations
- C. Maintain body temperature
- D. Prevent injury to lower extremities
Correct Answer: A
Rationale: Bilateral edema in heart failure results from increased venous pressure and congestion due to impaired cardiac output. The priority goal is to decrease venous congestion (e.g., by elevating legs or using compression) to reduce edema and improve circulation. Respirations, temperature, and injury prevention are secondary in this context.
The nurse is preparing the discharge of a client with a metal joint. The nurse should instruct the client about which of the following? Select all that apply.
- A. Notify health care providers about the joint prior to invasive procedures.
- B. Avoid use of Magnetic Resonance Imaging (MRI) scans.
- C. Notify airport security that the joint may set off alarms on metal detectors.
- D. Refrain from carrying items weighing more than 5 lb.
- E. Limit fluid intake to 1,000 mL/day.
Correct Answer: A,C
Rationale: Notifying providers and airport security about the metal joint prevents complications and delays. MRI scans are generally safe with modern prostheses.
In preparing the client and the family for a postoperative stay in the intensive care unit (ICU) after open heart surgery, the nurse should explain that:
- A. The client will remain in the ICU for 5 days.
- B. The client will sleep most of the time while in the ICU.
- C. Noise and activity within the ICU are minimal.
- D. The client will receive medication to relieve pain.
Correct Answer: D
Rationale: Pain management is a priority post-open heart surgery, and clients receive medications to ensure comfort in the ICU.