Nokea
The nurse is caring for a client prescribed amphotericin b for a systemic fungal infection. The nurse should anticipate a prescription for which medication before the infusion? Select all that apply
- A. Diphenhydramine
- B. Acetaminophen
- C. 0.9% saline bolus
- D. Regular insulin
- E. Sodium bicarbonate
Correct Answer: A,B,C
Rationale: Amphotericin B infusions can cause infusion reactions and nephrotoxicity. Choice A (diphenhydramine) and Choice B (acetaminophen) are given to prevent infusion reactions like fever and chills. Choice C (0.9% saline bolus) helps protect the kidneys by ensuring adequate hydration. Choice D (insulin) and Choice E (sodium bicarbonate) are not routinely used.
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Before surgery for a known aortic aneurysm, the client's pulse pressure begins to widen, suggesting increased aortic valvular insufficiency. If the branches of the aortic arch are involved, the nurse should assess the client for:
- A. Low blood pressure
- B. Anxiety
- C. Headache
- D. Disorientation
Correct Answer: D
Rationale: Widening pulse pressure and aortic arch involvement in an aortic aneurysm suggest possible dissection affecting cerebral perfusion (e.g., carotid artery involvement), leading to disorientation or neurologic changes. Low blood pressure, anxiety, and headache are less specific or unrelated.
Two days after surgery, a client continues to take hydrocodone 7.5 mg and acetaminophen 500 mg (Lortab 7.5/500). What should the nurse ask the client before administering the pain medication?
- A. œWhere is your pain located?'
- B. œHave you emptied your bladder?'
- C. œHow long has it been since your last dose?'
- D. œIs your pain better than before you had surgery?'
Correct Answer: C
Rationale: Asking about the time since the last dose ensures safe administration, preventing overdose or toxicity, as hydrocodone has a specific dosing interval.
A client is newly diagnosed with cancer and is beginning a treatment plan. Which of the following nursing interventions will be most effective in helping the client cope?
- A. Assume decision making for the client.
- B. Encourage the client's compliance with all treatment regimens.
- C. Inform the client of all possible adverse treatment effects.
- D. Identify available resources.
Correct Answer: D
Rationale: Identifying available resources (e.g., support groups, counseling) empowers the client to cope with the emotional and practical challenges of a new cancer diagnosis.
A nurse is assessing a client with Addison's disease. The nurse should review laboratory reports for which of the following?
- A. Hypokalemia.
- B. Hypernatremia.
- C. Hypoglycemia.
- D. Decreased blood urea nitrogen (BUN) level.
Correct Answer: C
Rationale: Hypoglycemia is common in Addison's disease due to cortisol deficiency, which impairs gluconeogenesis.
To provide oral hygiene for a client recovering from transsphenoidal hypophysectomy, the nurse should instruct the client to:
- A. Rinse the mouth with saline solution.
- B. Perform frequent toothbrushing.
- C. Clean the teeth with an electric toothbrush.
- D. Floss the teeth thoroughly.
Correct Answer: A
Rationale: Saline mouth rinses are gentle and safe post-transsphenoidal hypophysectomy, avoiding irritation to the surgical site.