Nokea
The nurse is caring for a client who has heart failure and a history of asthma. The nurse reviews the provider's orders and recognizes that clarification is needed for which of the following medications?
- A. Furosemide
- B. Carvedilol
- C. Spironolactone
- D. Lisinopril
Correct Answer: B
Rationale: The correct answer is B: Carvedilol. Carvedilol is a beta-blocker, which can exacerbate asthma symptoms in clients with a history of asthma due to its potential bronchoconstrictive effects. Furosemide (A), Spironolactone (C), and Lisinopril (D) are commonly used in heart failure management and do not pose a significant risk for clients with asthma. It is crucial to avoid medications that can worsen respiratory function in clients with a history of asthma to prevent complications.
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A nurse is caring for a client who reports a new onset of severe chest pain. Which of the following actions should the nurse take to determine if the client is experiencing a myocardial infarction?
- A. Perform a 12-lead ECG
- B. Administer nitroglycerin
- C. Place the client in a prone position
- D. Assess the client's blood pressure
Correct Answer: A
Rationale: The correct answer is A: Perform a 12-lead ECG. This is because an ECG is the most reliable and direct way to assess for myocardial infarction by identifying characteristic changes in the heart's electrical activity. Nitroglycerin (B) is used to relieve chest pain but should not be administered before confirming the diagnosis. Placing the client in a prone position (C) is not appropriate for assessing chest pain. Assessing blood pressure (D) is important but not the initial priority when suspecting myocardial infarction.
A nurse is caring for a client who has advanced lung cancer. The client's provider has recommended hospice services for the client. Which of the following statements by the client indicates a correct understanding of hospice care?
- A. I should expect the hospice team to help me manage my dyspnea.
- B. I will receive chemotherapy to treat my cancer.
- C. I will be admitted to the hospital for further treatment.
- D. I will receive radiation therapy to shrink the tumor.
Correct Answer: A
Rationale: Correct Answer: A - "I should expect the hospice team to help me manage my dyspnea."
Rationale: Hospice care focuses on providing comfort and quality of life for patients with terminal illnesses, such as advanced lung cancer. Dyspnea (difficulty breathing) is a common symptom in lung cancer patients, and the hospice team is trained to provide symptom management and relief. By acknowledging the role of the hospice team in managing dyspnea, the client demonstrates an understanding of the palliative nature of hospice care.
Summary of other choices:
B: "I will receive chemotherapy to treat my cancer." - Hospice care does not aim to cure the underlying illness but rather focuses on comfort and quality of life.
C: "I will be admitted to the hospital for further treatment." - Hospice care is typically provided in the comfort of the patient's own home or a hospice facility, not in a hospital setting for further treatment.
D: "I will receive radiation therapy
A nurse in an emergency room is caring for a client who sustained partial-thickness burns to both lower legs, chest, face, and both forearms. Which of the following is the priority action the nurse should take?
- A. Inspect the mouth for signs of inhalation injuries
- B. Administer pain medication
- C. Place the client on oxygen therapy
- D. Start an intravenous line
Correct Answer: A
Rationale: The correct answer is A: Inspect the mouth for signs of inhalation injuries. This is the priority action because inhalation injuries can be life-threatening and must be assessed immediately in burn patients. Burns to the face and chest increase the risk of inhalation injuries due to the proximity to the airway. Administering pain medication, placing the client on oxygen therapy, and starting an IV line are important interventions but inspecting the mouth for signs of inhalation injuries takes precedence in this situation to ensure the client's airway is not compromised.
A nurse is caring for a client who is receiving cisplatin to treat bladder cancer. After several treatments, the client reports fatigue. Which of the following actions should the nurse take?
- A. Check the results of the client's most recent CBC
- B. Administer a blood transfusion
- C. Offer the client a stimulant medication
- D. Advise the client to reduce physical activity
Correct Answer: A
Rationale: The correct answer is A: Check the results of the client's most recent CBC. Fatigue is a common side effect of cisplatin, which can cause bone marrow suppression leading to anemia. Checking the CBC will help determine if the client is experiencing anemia, which can be managed with appropriate interventions. Administering a blood transfusion (B) should not be done without confirming the need through lab results. Offering a stimulant medication (C) may mask the underlying cause of fatigue. Advising the client to reduce physical activity (D) may not address the root cause of the fatigue.
A nurse is reviewing the laboratory findings for a client who developed fat embolism syndrome (FES) following a fracture. Which of the following laboratory findings should the nurse expect?
- A. Increased serum calcium level
- B. Decreased serum calcium level
- C. Increased white blood cell count
- D. Decreased platelet count
Correct Answer: B
Rationale: The correct answer is B: Decreased serum calcium level. In fat embolism syndrome (FES), fat globules enter the bloodstream, leading to blockages in small blood vessels. This can cause a decrease in serum calcium due to the formation of fat emboli in the pulmonary circulation, leading to hypoxia and subsequent release of inflammatory mediators that can affect calcium levels. The other choices are incorrect because in FES, there is no direct effect on serum calcium levels. Increased serum calcium levels (choice A) are not expected in FES. While increased white blood cell count (choice C) and decreased platelet count (choice D) can occur in response to inflammation or infection associated with FES, they are not specific laboratory findings for FES.