Nokea
The nurse is caring for a client who had surgery yesterday. When administering omeprazole, the client asks 'What is that for? I don't take it at home.' Which reply by the nurse is most appropriate?
- A. Omeprazole helps prevent nausea by making your stomach empty faster.'
- B. Omeprazole helps prevent you from developing an ulcer due to the stress of surgery.'
- C. Omeprazole protects you from getting an infection while on antibiotics.'
- D. This medication will treat your gastroesophageal reflux disease (GERD).'
Correct Answer: B
Rationale: Omeprazole is a proton pump inhibitor used postoperatively to prevent stress ulcers due to surgical stress. It does not affect gastric emptying , prevent infections , or assume GERD without a diagnosis.
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The client has contact dermatitis from poison ivy. Which statement, if made by the client, indicates that he understands how to care for his condition?
- A. A hot bath should make the itching go away.'
- B. I will use a good strong soap when I wash the affected areas.'
- C. A cool wet cloth to the area should help.'
- D. Wearing wool socks will help my itchy feet.'
Correct Answer: C
Rationale: A cool wet cloth soothes itching and inflammation in contact dermatitis. Hot baths, strong soaps, or wool exacerbate irritation.
A client is scheduled for a myelogram. Which of the following medications orders should be questioned?
- A. Ampicillin (Pencipen) $250 \mathrm{mg} \mathrm{PO} \mathrm{q} 6$ hours
- B. Motrin (Ibuprofen) $400 \mathrm{mg} \mathrm{PO} \mathrm{q} 4$ hours PRN for headache
- C. Secobarbital (Seconal) $50 \mathrm{mg}$ HS PRN for sleep
- D. Propoxyphene (Darvon) $65 \mathrm{mg} \mathrm{PO} \mathrm{q} 4$ hours for pain
Correct Answer: B
Rationale: Ibuprofen (Motrin) has anticoagulant properties, increasing bleeding risk during a myelogram, a procedure involving spinal puncture. Other medications are safer.
The registered nurse and practical nurse are conducting a workshop on contraceptive methods for a group of outpatient clients. Which instructions should the nurses include when discussing combined estrogen-progestin oral contraceptives? Select all that apply.
- A. Consult the health care provider (HCP) if you experience leg pain or swelling
- B. Discontinue contraceptives if you experience spotting between menses
- C. Do not smoke while taking combined contraceptives
- D. Immediately report any breast tenderness to the HCP
- E. Seek immediate medical treatment if you experience vision loss
Correct Answer: A,C,E
Rationale: For combined oral contraceptives: report leg pain/swelling for possible DVT; avoid smoking due to increased cardiovascular risk; and seek treatment for vision loss indicating possible stroke. Spotting is common and breast tenderness is not urgent.
The nurse is reinforcing instructions to a client scheduled for cardiac pharmacologic nuclear stress testing. Which client statements indicate appropriate understanding?
- A. I can smoke 1 cigarette the day of the test so that I won't have withdrawal.'
- B. I should eat a hearty breakfast the morning of the test to avoid nausea.'
- C. I should stop drinking coffee 24 hours before the procedure.'
- D. I should take my usual dose of insulin the day of the test.'
Correct Answer: C,D
Rationale: Stopping coffee 24 hours before prevents interference with the stress test, and taking insulin as usual maintains glycemic control. Smoking and eating a large meal can alter test results.
The drug of choice for managing status epilepticus is:
- A. Carbamazepine (Tegretol)
- B. Diazepam (Valium)
- C. Clonazepam (Klonopin)
- D. Valproic acid (Depakene)
Correct Answer: B
Rationale: Diazepam is the first-line treatment for status epilepticus due to its rapid onset in stopping seizures.