Nokea
The nurse is caring for a client with a history of hyperthyroidism who is prescribed methimazole (Tapazole). The nurse should monitor the client for which of the following adverse effects?
- A. Agranulocytosis.
- B. Hypertension.
- C. Hyperglycemia.
- D. Weight loss.
Correct Answer: A
Rationale: Methimazole can cause agranulocytosis, a serious reduction in white blood cells, requiring monitoring.
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On the night before a 58-year-old wife and mother is to have a lobectomy for lung cancer, she remarks to the nurse, 'I am so scared of this cancer. I should have quit smoking years ago. Now I've brought all this fear and sadness on myself and now my family.' The nurse should tell the client:
- A. It's normal to be scared. I would be, too. We'll help you through it.'
- B. Do you feel guilty because you smoked?'
- C. Don't be so hard on yourself. You don't know if your smoking caused the cancer.'
- D. I can imagine how scared you are. What is it about cancer that you're afraid of?'
Correct Answer: D
Rationale: Acknowledging the client's fear and exploring specific concerns fosters therapeutic communication, helping address her emotions effectively.
The nurse is caring for a client post-myocardial infarction. Which activity should the nurse encourage to promote recovery?
- A. Bed rest for 48 hours
- B. Light ambulation as tolerated
- C. Heavy lifting after 24 hours
- D. High-intensity exercise
Correct Answer: B
Rationale: Light ambulation as tolerated promotes circulation and prevents complications like deep vein thrombosis, while avoiding overexertion post-myocardial infarction.
When a daily dose of fluoxetine hydrochloride is prescribed for a client, the nurse provides instructions regarding its administration. Which statement by the client indicates an understanding regarding the administration of the medication?
- A. I should take the medication with food only.
- B. It is best to take the medication in the morning.
- C. I should take the medication at bedtime with a snack.
- D. I should take the medication at noontime with an antacid.
Correct Answer: B
Rationale: A daily dose of fluoxetine hydrochloride, a selective serotonin reuptake inhibitor (SSRI), should be taken in the morning. If the medication is prescribed more than once daily, then the client is instructed to take the last dose of the day before 4:00 pm to avoid insomnia. It does not have to be taken with food. Antacids are avoided with its administration because the antacid will affect absorption.
The nurse is caring for a client with a history of burns. Which of the following complications should the nurse monitor for in the acute phase?
- A. Hypovolemia.
- B. Hypernatremia.
- C. Hypoglycemia.
- D. Respiratory alkalosis.
Correct Answer: A
Rationale: Hypovolemia is a major complication in the acute phase of burns due to fluid loss.
The staff nurse is reviewing how to manage the last 2 hours of the night shift on an antepartal unit and has the following orders and tasks to complete prior to 7 a.m. The nurse should complete the tasks in which order?
- A. Check documentation, final check of each client.
- B. Fetal monitor strip for 1/2 hour q shift.
- C. Magnesium sulfate drawn at 6 a.m.
- D. Accucheck and sliding scale insulin due at 7, 11, 4, and hs.
Correct Answer: D,G,F,A
Rationale: To manage time effectively: Check documentation and final client checks at 6:30 to ensure all records are complete (A); perform the fetal monitor strip from 6:00 to 6:30 to meet the half-hour requirement (F); draw magnesium sulfate at 6:00 to align with the ordered time (G); perform Accucheck and insulin at 7:00 as per the schedule (D).