Nokea
The nurse is caring for a client with angle-closure glaucoma. Which prescription should the nurse anticipate from the primary healthcare provider (PHCP)?
- A. Acetazolamide
- B. Diphenhydramine
- C. Phenylephrine
- D. Nortriptyline
Correct Answer: A
Rationale: Acetazolamide is a carbonic anhydrase inhibitor used to reduce intraocular pressure in angle-closure glaucoma by decreasing aqueous humor production. Diphenhydramine, phenylephrine, and nortriptyline are not indicated for this condition.
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What is the nurse's priority for a client with Guillain-Barré syndrome?
- A. Monitor respiratory function.
- B. Assess pain levels.
- C. Check skin integrity.
- D. Evaluate bowel function.
Correct Answer: A
Rationale: Monitoring respiratory function is the priority due to potential respiratory muscle weakness in Guillain-Barré syndrome.
A physician orders vitamin B12 for a client with pernicious anemia. Which site is appropriate for the nurse to administer vitamin B12? Select all that apply.
- A. Deltoid.
- B. Greater femur trochanter.
- C. Acromion muscle.
- D. Ventrogluteal.
- E. Upper back.
- F. Dorsogluteal.
Correct Answer: A,D,F
Rationale: Vitamin B12 is administered intramuscularly, and appropriate sites include the deltoid, ventrogluteal, and dorsogluteal muscles, as these provide adequate muscle mass for absorption. The greater femur trochanter and acromion muscle are not standard injection sites, and the upper back is not suitable for intramuscular injections.
The nurse has assisted the physician at the bedside with insertion of a left subclavian, triple lumen catheter in a client admitted with lung cancer. Suddenly, the client becomes restless and tachypneic. The nurse should:
- A. Assess breath sounds.
- B. Remove the catheter.
- C. Insert a peripheral I.V.
- D. Reposition the client.
Correct Answer: A
Rationale: Restlessness and tachypnea post-catheter insertion suggest a pneumothorax, a complication. Assessing breath sounds detects absent or diminished sounds, guiding intervention. Removing the catheter, inserting an I.V., or repositioning does not address the urgent issue.
A client has a history of heart failure and has been taking several medications, including furosemide (Lasix), digoxin (Lanoxin) and potassium chloride. The client has nausea, blurred vision, headache, and weakness. The nurse notes that the client is confused. The telemetry strip shows first-degree atrioventricular block. The nurse should assess the client for signs of which condition?
- A. Hyperkalemia.
- B. Digoxin toxicity.
- C. Fluid deficit.
- D. Pulmonary edema.
Correct Answer: B
Rationale: Nausea, blurred vision, confusion, and AV block are classic signs of digoxin toxicity, especially in a client taking digoxin, requiring immediate assessment.
A suspected outbreak of anthrax has been transmitted by skin exposure. A client is admitted to the emergency department with lesions on the hands. The physician prescribes antibiotics and sends the client home. What should the nurse instruct the client to do? Select all that apply.
- A. Take the prescribed antibiotics for 60 days.
- B. Avoid contact with other members of the family during the treatment period.
- C. Wear a mask for 60 days.
- D. Expect the skin lesions to clear up within 1 to 2 weeks.
- E. Wash hands frequently.
Correct Answer: A,D,E
Rationale: Cutaneous anthrax requires antibiotics for 60 days, frequent hand washing to prevent spread, and lesions typically resolve in 1-2 weeks with treatment. Masks and family isolation are unnecessary for cutaneous anthrax.