Nokea
The nurse is caring for a client in the clinic who takes captopril and ramipril for hypertension. The health care provider renews the client's prescriptions and leaves the room. Which comment by the client would prompt the nurse to notify the health care provider immediately?
- A. I am able to start walking longer at the gym without getting tired.
- B. Occasionally I am slightly dizzy when standing, so I get up slowly.
- C. I don't get short of breath anymore now that my blood pressure is controlled.
- D. I am going to my gynecologist tomorrow for my 12-week pregnancy checkup.
Correct Answer: D
Rationale: Captopril and ramipril (ACE inhibitors) are contraindicated in pregnancy due to fetal harm, requiring immediate provider notification.
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A client with Crohn's disease requires TPN to provide adequate nutrition. The nurse finds the TPN bag empty. What fluid would the nurse select to hang until another bag is prepared in the pharmacy?
- A. Lactated Ringers
- B. Normal saline
- C. D10W
- D. Normosol R
Correct Answer: C
Rationale: D10W provides dextrose to prevent hypoglycemia, a risk when TPN (high in glucose) is abruptly stopped. Saline or other fluids don't provide necessary glucose.
The physician has ordered an infusion of Osmitrol (mannitol) for a client with increased intracranial pressure. Which finding indicates the direct effectiveness of the drug?
- A. Increased pulse rate
- B. Increased urinary output
- C. Decreased diastolic blood pressure
- D. Increased pupil size
Correct Answer: B
Rationale: Mannitol is an osmotic diuretic that reduces intracranial pressure by increasing urinary output, drawing fluid out of the brain tissue.
A client with $B$ positive blood is scheduled for a transfusion of whole blood. Which finding requires nursing intervention?
- A. The available blood has been banked for 2 weeks.
- B. The blood available for transfusion is Rh negative.
- C. The client has a peripheral IV of D5 $1 / 2$ normal saline.
- D. The blood available for transfusion is type 0 positive.
Correct Answer: B
Rationale: Transfusing Rh-negative blood to an Rh-positive client can cause incompatibility reactions, requiring intervention to ensure Rh compatibility.
The nurse is caring for a client admitted with acute laryngotracheobronchitis (LTB). Because of the possibility of complete obstruction of the airway, which of the following should the nurse have available?
- A. Intravenous access supplies
- B. Emergency intubation equipment
- C. Intravenous fluid-administration pump
- D. Supplemental oxygen
Correct Answer: B
Rationale: Emergency intubation equipment is essential for LTB due to the risk of airway obstruction requiring immediate intervention.
The nurse is caring for a client with a malignancy. The classification of the primary tumor is Tis. The nurse should plan care for a tumor:
- A. That cannot be assessed
- B. That is in situ
- C. With increasing lymph node involvement
- D. With distant metastasis
Correct Answer: B
Rationale: Tis indicates a tumor in situ, meaning it is noninvasive and confined to its original site, requiring specific care planning.