Nokea
The nurse is caring for a client with asthma who has developed gastroesophageal reflux disease (GERD). Which of the following medications prescribed for the client may aggravate GERD?
- A. Anticholinergics
- B. Corticosteroids
- C. Histamine blocker
- D. Antibiotics
Correct Answer: A
Rationale: An anticholinergic medication will decrease gastric emptying and the pressure on the lower esophageal sphincter.
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A client with angina is experiencing migraine headaches. The physician has prescribed sumatriptan succinate (Imitrex). Which nursing action is most appropriate?
- A. Consult with the RN before administration.
- B. Try to obtain samples for the client to take home.
- C. Perform discharge teaching regarding this drug.
- D. Consult social services for financial assistance with obtaining the drug.
Correct Answer: A
Rationale: Sumatriptan is contraindicated in clients with angina due to its vasoconstrictive effects, which could exacerbate cardiac ischemia. Consulting the RN to verify the order is the most appropriate action. Obtaining samples, discharge teaching, or consulting social services do not address the safety concern, so answers B, C, and D are incorrect.
The nurse is caring for an adult who is enrolled in a study involving an experimental drug. The client says to the nurse, 'I don't think I can stand the vomiting anymore. I think it is due to the drug I am taking. If only I could get out of this study I signed up for. That was a really stupid thing I did when I signed up for the study.' What information must the nurse include when responding to the client?
- A. If the client signed the proper forms, the client is committed to the study.
- B. Persons who have signed up for a study may opt out of the study at any time.
- C. The person should discuss his/her concerns with the researchers.
- D. Inform the client that there are drugs that can control nausea.
Correct Answer: B
Rationale: Participants can withdraw from research studies at any time, per ethical research guidelines, ensuring autonomy and safety.
The nurse is caring for a client who is postoperative day 1 after a total knee replacement. Which of the following actions is the PRIORITY?
- A. Encourage the client to use the incentive spirometer.
- B. Administer pain medication as needed.
- C. Apply a continuous passive motion (CPM) machine.
- D. Check the surgical dressing for drainage.
Correct Answer: C
Rationale: Applying the CPM machine is the priority to prevent stiffness and promote joint mobility post-knee replacement. Options A, B, and D are important but secondary: incentive spirometry prevents pneumonia, pain management supports recovery, and dressing checks monitor bleeding.
A client has just returned to the medical-surgical unit following a segmental lung resection. After assessing the client, the first nursing action would be to
- A. Administer pain medication
- B. Suction excessive tracheobronchial secretions
- C. Assist client to turn, deep breathe and cough
- D. Monitor oxygen saturation
Correct Answer: B
Rationale: Suction excessive tracheobronchial secretions. Suctioning the copious tracheobronchial secretions present in post-thoracic surgery clients maintains an open airway, which is always the priority nursing intervention.
A client recently diagnosed with bipolar disorder expresses concern over taking Eskalith (lithium carbonate) because 'a lot of people have problems getting too much of it.' The nurse should explain that lithium toxicity typically occurs when the client has an insufficient intake of:
- A. Carbohydrates for energy
- B. Protein for maintenance of cell integrity
- C. Potassium for muscle contractility
- D. Sodium and fluids for renal excretion
Correct Answer: D
Rationale: Lithium toxicity occurs with insufficient sodium and fluids, as low sodium increases lithium reabsorption in kidneys, and fluids aid excretion. Other nutrients are less directly related.