Nokea
The nurse is caring for a client who is receiving procainamide (Pronestyl) intravenously. It is important for the nurse to monitor which of the following parameters?
- A. Hourly urinary output
- B. Serum potassium levels
- C. Continuous EKG readings
- D. Neurological signs
Correct Answer: C
Rationale: Continuous EKG readings. Procainamide (Pronestyl) is used to suppress cardiac arrhythmias. When administered intravenously, it must be accompanied by continuous cardiac monitoring by ECG.
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The client is exhibiting multifocal premature ventricular contractions. Which antidysrhythmic medication should the nurse anticipate the HCP ordering for this dysrhythmia?
- A. Adenosine.
- B. Epinephrine.
- C. Atropine.
- D. Amiodarone.
Correct Answer: D
Rationale: Amiodarone is effective for ventricular dysrhythmias like PVCs, per ACLS guidelines. Adenosine, epinephrine, or atropine are used for other rhythms.
The clinic nurse is teaching an adult male who has AIDS. He is receiving zidovudine. Which statement he makes indicates that he understands the medication regimen?
- A. If I get a sore throat and it is hard to swallow my capsules, I can empty the capsule into applesauce.
- B. I am hopeful that this drug will get rid of this awful disease.
- C. I understand I might need a transfusion.
- D. I should take acetaminophen (Tylenol), not aspirin, if I get a fever.
Correct Answer: D
Rationale: Zidovudine can cause bone marrow suppression; acetaminophen is safer than aspirin, which increases bleeding risk.
A client with an aplastic sickle cell crisis is receiving a blood transfusion and begins to complain of 'feeling hot.' Almost immediately, the client begins to wheeze. What is the nurse's first action?
- A. Stop the blood infusion
- B. Notify the health care provider
- C. Take/record vital signs
- D. Send blood samples to lab
Correct Answer: A
Rationale: Stop the blood infusion. If a reaction of any type is suspected during administration of blood products, stop the infusion immediately, keep the line open with saline, notify the health care provider, monitor vital signs and other changes, and then send a blood sample to the lab.
The male client is self-medicating with the H-2 antagonist cimetidine (Tagamet). Which complication can occur while taking this medication?
- A. Melena.
- B. Gynecomastia.
- C. Pyrosis.
- D. Eructation.
Correct Answer: B
Rationale: Cimetidine can cause gynecomastia due to antiandrogen effects, especially in males. Melena, pyrosis, or eructation are unrelated.
A client is receiving dexamethasone (Decadron) therapy. What should the nurse plan to monitor in this client?
- A. Urine output every 4 hours
- B. Blood glucose levels every 12 hours
- C. Neurological signs every 2 hours
- D. Oxygen saturation every 8 hours
Correct Answer: B
Rationale: The drug Decadron increases gluconeogenesis. This may lead to hyperglycemia. Therefore the blood sugar level and acetone production must be monitored.