Nokea
The nurse is caring for a client who abuses narcotics. The client is exhibiting a respiratory rate of 10 and dilated pupils. Which drug would the nurse expect to administer?
- A. Meperidine (Demerol)
- B. Naloxone (Narcan)
- C. Chlordiazepoxide (Librium)
- D. Haloperidol (Haldol)
Correct Answer: B
Rationale: Respiratory depression (rate of 10) and dilated pupils suggest opioid overdose. Naloxone (Narcan) is the antidote to reverse opioid toxicity.
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Which of the following are risk factors for developing glaucoma? Select all that apply.
- A. asthma
- B. pernicious anemia
- C. diabetes mellitus
- D. obesity
- E. hypertension
Correct Answer: C,E
Rationale: Diabetes mellitus and hypertension increase glaucoma risk by affecting ocular blood flow and pressure. Asthma, anemia, and obesity are not direct risk factors.
A client with cervical cancer has a radioactive implant. Which statement indicates that the client understands the nurse's teaching regarding radioactive implants?
- A. I won't be able to have visitors while getting radiation therapy.
- B. I will have a urinary catheter while the implant is in place.
- C. I can be up to the bedside commode while the implant is in place.
- D. I won't have any side effects from this type of therapy.
Correct Answer: C
Rationale: Clients with radioactive implants can use the bedside commode if the implant remains secure, indicating understanding of mobility restrictions to minimize radiation exposure.
A pediatric client is admitted to the hospital for treatment of diarrhea caused by an infection with salmonella. Which of the following most likely contributed to the child's illness?
- A. Brushing the family dog
- B. Playing with a turtle
- C. Taking a pony ride
- D. Feeding the family cat
Correct Answer: B
Rationale: Turtles are common carriers of Salmonella, which can be transmitted to children through handling, leading to gastrointestinal infection.
A nurse is observing a local softball game when one of the players is hit in the nose with a ball. The player's nose is visibly deformed and bleeding. The best way for the nurse to control the bleeding is to:
- A. Tilt the head back and pinch the nostrils
- B. Apply a wrapped ice compress to the nose
- C. Pack the nose with soft, clean tissue
- D. Tilt the head forward and pinch the nostrils
Correct Answer: D
Rationale: Tilting the head forward and pinching the nostrils prevents blood from entering the airway and controls bleeding.
A client with schizophrenia is started on Zyprexa (olanzapine). Three weeks later, the client develops severe muscle rigidity and elevated temperature. The nurse should give priority to:
- A. Withholding all morning medications
- B. Ordering a CBC and CPK
- C. Administering prescribed anti-Parkinsonian medication
- D. Transferring the client to a medical unit
Correct Answer: D
Rationale: Severe muscle rigidity and fever suggest neuroleptic malignant syndrome (NMS), a medical emergency requiring immediate transfer to a medical unit for treatment.