Nokea
The nurse is caring for a client who is newly prescribed cimetidine. The nurse understands that this medication is prescribed to treat which condition?
- A. Cystic fibrosis
- B. Clostridium difficile
- C. H. pylori infection
- D. Crohn’s disease
Correct Answer: C
Rationale: Cimetidine, an H2 receptor blocker, is used in H. pylori infection to reduce gastric acid, aiding in ulcer healing alongside antibiotics. It is not indicated for cystic fibrosis, C. difficile, or Crohn’s disease.
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The nurse is caring for a 26-year-old patient who cannot meet their nutritional needs by mouth. The interdisciplinary team decided inserting an NG tube for enteral feedings would be best. After inserting the tube, the nurse knows which of the following is the most accurate way to verify the placement of the tube?
- A. Aspiration of stomach contents
- B. pH verification of the aspirate
- C. Injecting air into the tube and then auscultating the left upper quadrant (LUQ)
- D. Visualization on an X-ray
Correct Answer: D
Rationale: X-ray visualization (D) is the most accurate method to confirm NG tube placement, ensuring it is in the stomach and not the lungs.
The nurse is caring for a client who recently had a partial gastrectomy. Which of the following medications should the nurse anticipate that the primary health care provider (PHCP) will order?
- A. Cyanocobalamin
- B. Metoclopramide
- C. Sucralfate
- D. Hydroxyzine
Correct Answer: A
Rationale: Cyanocobalamin (A) is anticipated post-gastrectomy to prevent vitamin B12 deficiency due to reduced intrinsic factor production.
A nurse is caring for a client with ulcerative colitis who has experienced severe diarrhea for the past 24 hours. When assessing the client, the nurse should watch for signs of which of the following?
- A. Metabolic acidosis
- B. Metabolic alkalosis
- C. Malnutrition
- D. Malabsorption
Correct Answer: C
Rationale: Severe diarrhea in ulcerative colitis leads to nutrient loss, increasing the risk of malnutrition (C). Acid-base imbalances (A, B) and malabsorption (D) are possible but less immediate concerns.
A client recently diagnosed with peptic ulcer disease is being discharged. While the nurse provides discharge teaching, which of the following over-the-counter medications should the client be instructed to avoid?
- A. Calcium
- B. Magnesium
- C. Sodium
- D. Aspirin
Correct Answer: D
Rationale: Aspirin can irritate the gastric mucosa and increase the risk of bleeding in peptic ulcer disease. Calcium, magnesium, and sodium (in typical OTC forms) do not typically exacerbate ulcers.
The nurse cares for a client four days postoperative following an open splenectomy. The client's vital signs are T 101.1°F (38.4°C), P 92, RR 17, BP 152/86, and pulse oximetry reading 95% on oxygen at 2 L/min via nasal cannula. The surgical wound is assessed to have erythema and purulent drainage. The nurse should take which actions? Select all that apply.
- A. Request an order for an antibiotic
- B. Notify the physician
- C. Ambulate the client to the bedside chair
- D. Obtain an order for blood cultures
- E. Increase the nasal cannula oxygen to 4 L/minute
Correct Answer: A,B,D
Rationale: Fever, erythema, and purulent drainage suggest infection, requiring notifying the physician (B), requesting antibiotics (A), and obtaining blood cultures (D). Ambulation (C) and increasing oxygen (E) are not indicated.