Nokea
The nurse is caring for a client with pneumonia who is allergic to penicillin. Which antibiotic is safest to administer to this client?
- A. Cefazolin (Ancef)
- B. Amoxicillin
- C. Erythrocin (Erythromycin)
- D. Ceftriaxone (Rocephin)
Correct Answer: C
Rationale: Erythromycin, a macrolide, is safe for penicillin-allergic patients. Cefazolin (A), Amoxicillin (B), and Ceftriaxone (D) are beta-lactams with cross-reactivity risks.
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The nurse discovers that a 78-year-old client who received hydralazine (Apresoline) 20 mg 45 minutes ago has a blood pressure of 70/40 mm Hg. The client has been on this dose of the medication for 3 years. Which of the following data is most likely significant in relation to the cause of the low blood pressure?
- A. Pedal pulses 11 (weak)
- B. Twenty-four-hour intake 1000 mL/day for past 2 days
- C. Serum potassium 3.3
- D. Pulse rate 150 bpm
Correct Answer: B
Rationale: (A, D) Decreased pulse volume and increased pulse rate are signs of an acute hypotensive episode. Inadequate fluid volume when taking vasodilators can result in a drop in blood pressure when vasodilation starts to physiologically occur as an action of the drug. A potassium level of 3.3 would not be associated with a significant drop in blood pressure.
A long-term goal for the nurse in planning care for a depressed, suicidal client would be to:
- A. Provide him with a safe and structured environment.
- B. Assist him to develop more effective coping mechanisms.
- C. Have him sign a 'no-suicide' contract.
- D. Isolate him from stressful situations that may precipitate a depressive episode.
Correct Answer: B
Rationale: This statement represents a short-term goal. Long-term therapy should be directed toward assisting the client to cope effectively with stress. Suicide contracts represent short-term interventions. This statement represents an unrealistic goal. Stressful situations cannot be avoided in reality.
The nurse is preparing to collect a sputum specimen from the client suspected of having tuberculosis. What is the correct method for obtaining a sputum specimen?
- A. Collect the specimen in the morning prior to breakfast.
- B. Collect the specimen on three consecutive days.
- C. Transport the collected specimen to the laboratory immediately.
- D. Offer mouth care after collecting the sputum specimen.
- E. Allow the client to rinse his mouth with an antiseptic solution prior to the sputum collection.
Correct Answer: A, B, C, D
Rationale: Morning collection (A) yieldsthough sputum is most concentrated. Three consecutive days (B) ensure reliable tuberculosis diagnosis. Immediate transport (C) prevents degradation. Mouth care (D) maintains hygiene. Antiseptic rinse (E) may kill bacteria, invalidating the sample.
Which type of insulin can be administered by a continuous IV drip?
- A. Humulin N
- B. NPH insulin
- C. Regular insulin
- D. Lente insulin
Correct Answer: C
Rationale: Regular insulin is the only insulin that can be administered IV.
The nurse is teaching a client with a history of gout about dietary modifications. The nurse should tell the client to avoid:
- A. Green leafy vegetables
- B. Organ meats
- C. Whole grains
- D. Dairy products
Correct Answer: B
Rationale: Organ meats are high in purines, which increase uric acid levels, exacerbating gout, so they should be avoided.