Nokea
The nurse is caring for a client with a history of cirrhosis. Which of the following laboratory findings indicates a worsening condition?
- A. Elevated ammonia levels.
- B. Decreased bilirubin levels.
- C. Increased albumin levels.
- D. Decreased prothrombin time.
Correct Answer: A
Rationale: Elevated ammonia levels indicate worsening liver function and potential hepatic encephalopathy in cirrhosis.
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A client with a diagnosis of gout is prescribed naproxen. The nurse should instruct the client to:
- A. Take the medication with food to reduce stomach upset.
- B. Avoid drinking alcohol.
- C. Limit fluid intake.
- D. Take the medication at bedtime only.
Correct Answer: A,B
Rationale: Taking naproxen with food reduces gastrointestinal upset, and avoiding alcohol prevents uric acid buildup.
A nulliparous client visiting the clinic tells the nurse that she stopped taking oral contraceptives 6 months ago but doesn't think she is ovulating. Which of the following should the nurse anticipate that the physician would order if the client is anovulatory?
- A. Denestrol (Ortho Dienestrol)
- B. Clomiphene citrate (Clomid)
- C. Medroxyprogesterone (Depo-Provera)
- D. Norgestrel (Ovrette)
Correct Answer: B
Rationale: Clomiphene citrate is commonly prescribed to stimulate ovulation in anovulatory clients. Denestrol is an estrogen, medroxyprogesterone is a progestin for contraception or other uses, and norgestrel is a contraceptive, not for inducing ovulation.
When assessing a 2-month-old infant, the nurse feels a 'click' when abducting the infant's left hip. Which of the following should the nurse do next?
- A. Document the finding as normal for a 2-month-old.
- B. Check the lengths of the femurs to determine if they are equal.
- C. Instruct the mother to keep the leg in an adducted position.
- D. Reschedule the child for a follow-up assessment in 3 weeks.
Correct Answer: B
Rationale: A 'click' during hip abduction suggests developmental dysplasia of the hip, so checking femur lengths helps confirm asymmetry for further evaluation.
Prochlorperazine (Compazine) is prescribed postoperatively. The nurse should evaluate the drug's therapeutic effect when the client expresses relief from which of the following?
- A. Nausea.
- B. Dizziness.
- C. Abdominal spasms.
- D. Abdominal distention.
Correct Answer: A
Rationale: Prochlorperazine is primarily used to treat postoperative nausea and vomiting, so relief from nausea indicates therapeutic effectiveness.
The nurse is caring for a client with a spinal cord injury at the T4 level. Which of the following findings indicates autonomic dysreflexia?
- A. Bradycardia and hypertension.
- B. Tachycardia and hypotension.
- C. Fever and chills.
- D. Hypoxia and cyanosis.
Correct Answer: A
Rationale: Autonomic dysreflexia presents with bradycardia and hypertension due to unopposed sympathetic stimulation below the injury level.