Nokea
The nurse is caring for a client with a history of atrial fibrillation. Which medication is most likely to be prescribed to prevent thromboembolism?
- A. Warfarin (Coumadin)
- B. Aspirin
- C. Clopidogrel (Plavix)
- D. Heparin
Correct Answer: A
Rationale: Warfarin is commonly prescribed for atrial fibrillation to prevent thromboembolism by maintaining anticoagulation (target INR 2–3). Aspirin and clopidogrel are less effective, and heparin is used short-term.
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The client is admitted with a diagnosis of preterm labor. Which intervention is most appropriate?
- A. Administer betamethasone
- B. Monitor fetal heart tones
- C. Administer tocolytics
- D. All of the above
Correct Answer: D
Rationale: In preterm labor betamethasone enhances fetal lung maturity tocolytics (e.g. nifedipine) halt contractions and fetal heart tone monitoring assesses fetal well-being. All interventions are appropriate.
A female client is admitted to the emergency department complaining of severe right-sided abdominal pain and vaginal spotting. She states that her last menstrual period was about 2 months ago. A positive pregnancy test result and ultrasonography confirm an ectopic pregnancy. The nurse could best explain to the client that her condition is caused by:
- A. Abnormal development of the embryo
- B. A distended or ruptured fallopian tube
- C. A congenital abnormality of the tube
- D. A malfunctioning of the placenta
Correct Answer: B
Rationale: The embryo itself may develop normally in the first several weeks of an ectopic pregnancy. An ectopic pregnancy in the fallopian tube causes severe pain owing to the size of the growing embryo within the narrow lumen of the tube, causing distention and finally rupture within the first 12 weeks of pregnancy. The Fallopian tube may either be normal or contain adhesions caused by a history of pelvic inflammatory disease or tubal surgeries, neither of which are congenital causes. An ectopic pregnancy does not involve a dysfunctional placenta, but the implantation of the blastocyst outside the uterus.
Which of the following findings would be expected in the infant with biliary atresia?
- A. Rapid weight gain and hepatomegaly
- B. Dark stools and poor weight gain
- C. Abdominal distention and poor weight gain
- D. Abdominal distention and rapid weight gain
Correct Answer: C
Rationale: Biliary atresia causes bile flow obstruction, leading to abdominal distention (from hepatomegaly) and poor weight gain due to malabsorption. Stools are pale, not dark, and weight gain is not rapid.
A client with a history of renal failure is admitted with complaints of shortness of breath. The nurse should expect the client to have:
- A. Metabolic acidosis
- B. Metabolic alkalosis
- C. Respiratory acidosis
- D. Respiratory alkalosis
Correct Answer: A
Rationale: Renal failure impairs acid excretion, leading to metabolic acidosis, which can cause compensatory hyperventilation and shortness of breath.
An elderly patient has been taking 80 mg of furosemide (Lasix) bid. The nurse notes that the patient's most recent potassium level is 2.5mEq/L. The nurse should:
- A. Continue the medication as ordered
- B. Administer the morning dose only
- C. Give the medication with orange juice
- D. Withhold the medication and notify the physician
Correct Answer: D
Rationale: A potassium level of 2.5 mEq/L indicates hypokalemia, a serious side effect of furosemide, a potassium-wasting diuretic. The nurse should withhold the medication and notify the physician to address the electrolyte imbalance.