Nokea
The nurse is caring for a patient on warfarin with an elevated INR level. Which of the ff. would be ordered as the antidote for warfarin?
- A. Vitamin K c.Calcium Chloride
- B. Vitamin B12
- C. Protamine Sulfate
Correct Answer: A
Rationale: Warfarin is an anticoagulant medication that works by inhibiting the production of certain clotting factors in the liver, thus prolonging the time it takes for blood to clot. An elevated INR level indicates that the blood is taking longer to clot than desired, potentially putting the patient at risk for bleeding. Vitamin K is the antidote for warfarin because it helps the liver produce these clotting factors, ultimately reversing the effects of warfarin and promoting normal blood clotting. Administering Vitamin K helps lower the INR level and reduce the risk of bleeding in patients on warfarin therapy. Therefore, in this scenario, Vitamin K would be the appropriate antidote to use for the patient with an elevated INR level.
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Patients are at risk for overwhelming postsplenectomy infection (OPSI) following splenectomy. Which of the ff. symptoms alerts the nurse to this possibility?
- A. Bruising around the operative site
- B. Pain
- C. Irritability
- D. Fever
Correct Answer: D
Rationale: Patients who have undergone splenectomy are at risk for overwhelming postsplenectomy infection (OPSI) due to the absence of a functioning spleen, which is important in fighting certain types of infections, especially those caused by encapsulated bacteria such as Streptococcus pneumoniae. Symptoms of OPSI can include fever, chills, weakness, and rapid breathing. Fever is a significant sign that alerts the nurse to the possibility of OPSI in a post-splenectomy patient, as it may indicate an infection that the body is struggling to fight without the spleen's immune support. This is a crucial symptom to monitor and act upon promptly to prevent serious complications in these individuals.
The nurse is teaching a client with type 1 diabetes mellitus how to treat adverse reactions to insulin. To reverse a hypoglycemic reaction, the client ideally should ingest an oral carbohydrate. However, this treatment isn't always a possible or safe. Therefore, the nurse should advise the client to keep which alternate treatment on hand?
- A. Epinephrine
- B. 50% dextrose
- C. Glucagon
- D. Hydrocortisone
Correct Answer: C
Rationale: Glucagon is the hormone responsible for raising blood sugar levels in the body. In cases of severe hypoglycemic reactions where the client is unconscious or unable to ingest oral carbohydrates, glucagon can be administered via injection to help raise blood sugar levels rapidly. It is important for clients with type 1 diabetes mellitus to have glucagon on hand as a precautionary measure in case of severe hypoglycemic episodes. Epinephrine is typically used for severe allergic reactions, 50% dextrose is a form of oral carbohydrate, and hydrocortisone is a corticosteroid medication used for various conditions but not for treating hypoglycemia in clients with diabetes.
A client hyperparathyroidism declines surgery and is to receive hormone replacement therapy with estrogen and progesterone. Which of the following instructions would be most important to include in the client's teaching plan?
- A. maintain a moderate exercise
- B. Lose weight
- C. Jog at least 2 miles per day
- D. Rest as much as possible
Correct Answer: A
Rationale: The most important instruction to include in the client's teaching plan would be to maintain a moderate exercise routine (Option A). Regular physical activity is important for overall health, including helping to maintain bone health and strength. This is particularly crucial for individuals with hyperparathyroidism who are declining surgery and opting for hormone replacement therapy, as exercise can help to support bone density and reduce the risk of fractures. However, it is essential to emphasize that the exercise should be moderate and appropriate for the individual's current fitness level, as excessive exercise can have negative effects on bone health in this population.
The nurse is taking a sexual history on an adolescent girl. Which is the best way to determine whether she is sexually active?
- A. Ask her, "Are you sexually active?"
- B. Ask her, "Are you having sex with anyone?"
- C. Ask her, "Are you having sex with a boyfriend?"
- D. Ask both the girl and her parent whether she is sexually active.
Correct Answer: A
Rationale: The best way to determine whether an adolescent girl is sexually active is to ask her directly, "Are you sexually active?" This question is concise, clear, and non-judgmental, allowing the girl to provide a straightforward answer. It is important to create a safe and open environment for discussing sexual health, and using direct language helps ensure accurate communication. Asking about specific partners (options B and C) may lead to confusion or misinterpretation, and involving the parent (option D) without the girl's consent may violate her privacy and autonomy. Therefore, direct communication with the adolescent herself is the most appropriate approach to gather information about her sexual activity.
A 19 y.o. student develops trigeminal neuralgia. Which of the ff. actions will most likely aggravate her pain?
- A. Sleeping
- B. Reading
- C. Eating
- D. Cooking
Correct Answer: C
Rationale: Trigeminal neuralgia is a condition characterized by sudden and severe facial pain caused by irritation or damage to the trigeminal nerve. Trigeminal neuralgia pain is often triggered by certain activities that stimulate the nerve, such as eating, talking, or brushing teeth. The act of chewing and ingesting food can put pressure on the trigeminal nerve, leading to increased pain for individuals suffering from trigeminal neuralgia. Therefore, eating is most likely to aggravate the pain in a 19-year-old student with trigeminal neuralgia.