Nokea
The nurse is caring for a client reporting an abrupt onset of severe pain associated with metastatic cancer. Which prescription should the nurse plan to administer?
- A. fentanyl via transdermal patch
- B. pregabalin
- C. ketorolac
- D. hydromorphone
Correct Answer: D
Rationale: Hydromorphone is appropriate for rapid relief of severe, acute cancer pain due to its fast-acting opioid properties.
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After teaching the client with severe rheumatoid arthritis about prescribed methotrexate (Rheumatrex), which of the following statements indicates the need for further teaching?
- A. I will take my vitamins while I'm on this drug.'
- B. I must not drink any alcohol while I'm taking this drug.'
- C. I should brush my teeth after every meal.'
- D. I will continue taking my birth control pills.'
Correct Answer: A
Rationale: Methotrexate can interact with certain vitamins (e.g., folic acid) if not prescribed, requiring medical guidance. The other statements align with safe methotrexate use.
When caring for a client with a chest tube and water-seal drainage system, the nurse should:
- A. Verify that the air vent on the water-seal drainage system is capped when the suction is off.
- B. Strip the chest drainage tubes at least every 4 hours if excessive bleeding occurs.
- C. Ensure that the chest tube is clamped when moving the client out of the bed.
- D. Make sure that the drainage apparatus is always below the client's chest level.
Correct Answer: D
Rationale: Keeping the drainage apparatus below chest level prevents fluid backflow into the pleural space. Capping the vent, stripping tubes, or clamping during movement risks complications like pneumothorax.
What is the nurse's best response to a client with Parkinson's experiencing dyskinesia?
- A. Increase medication dose.
- B. Teach relaxation techniques.
- C. Restrict all activity.
- D. Ignore the symptoms.
Correct Answer: B
Rationale: Teaching relaxation techniques can help manage dyskinesia, a side effect of Parkinson's medications.
The nurse is administering packed red blood cells (PRBCs) to a client. The nurse should first:
- A. Discontinue the I.V. catheter if a blood transfusion reaction occurs.
- B. Administer the PRBCs through a percutaneously inserted central catheter line with a 20-gauge needle.
- C. Flush PRBCs with 5% dextrose and 0.45% normal saline solution.
- D. Stay with the client during the first 15 minutes of infusion.
Correct Answer: D
Rationale: The nurse should stay with the client during the first 15 minutes of a blood transfusion, as this is the most likely time for a transfusion reaction to occur. Close monitoring allows for immediate intervention if a reaction is detected. Discontinuing the IV is only done if a reaction occurs, PRBCs should not be administered via a 20-gauge needle (a larger gauge is needed), and dextrose solutions are incompatible with PRBCs.
When discussing recent onset of feelings of sadness and depression in a client with hypothyroidism, the nurse should inform the client that these feelings are:
- A. The effects of thyroid hormone replacement therapy and will diminish over time.
- B. Related to thyroid hormone replacement therapy and will not diminish over time.
- C. A normal part of having a chronic illness.
- D. Most likely related to low thyroid hormone levels and will improve with treatment.
Correct Answer: D
Rationale: Low thyroid hormone levels in hypothyroidism can cause depression and sadness, which typically improve with thyroid hormone replacement therapy.