Nokea
The nurse is discharging a client who is prescribed antitubercular medications for pulmonary tuberculosis. The nurse is concerned about an adverse reaction to the medications if the client
- A. lives with a roommate and works as a flight attendant.
- B. has an implanted hormonal intrauterine device (IUD).
- C. smokes one pack of cigarettes per day.
- D. drinks three glasses of red wine each day.
Correct Answer: D
Rationale: Alcohol consumption, such as drinking three glasses of red wine daily, increases the risk of hepatotoxicity when taking antitubercular medications like isoniazid and rifampin, which are metabolized by the liver. Choice A is irrelevant to medication reactions, though it may pose a transmission risk. Choice B (IUD) and Choice C (smoking) do not directly interact with antitubercular medications to cause adverse reactions.
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A client who has undergone a mitral valve replacement has persistent bleeding from the sternal incision during the early postoperative period. The nurse should do which of the following? Select all that apply.
- A. Begin Warfarin (Coumadin).
- B. Check the postoperative CBC, INR, PTT, & platelet levels.
- C. Confirm availability of blood products.
- D. Monitor the mediastinal chest tube drainage.
- E. Start a Dopamine (Intropin) drip for a systolic BP <100.
Correct Answer: B,C,D
Rationale: Checking lab values (B), confirming blood products (C), and monitoring chest tube drainage (D) address bleeding and ensure timely intervention. Warfarin and dopamine are inappropriate for acute bleeding.
A 62-year-old Chinese man is admitted with multiple injuries from a motor vehicle accident. He complains of severe pain and requests frequent medication. One of the assistive nursing personnel expresses surprise, saying, "I thought Asian people were very stoic about pain." Which is the nurse's best response about pain?
- A. Expression and perception of pain vary widely from person to person.
- B. Tolerance of pain is the same in all people.
- C. Tolerance of pain is determined by a person's genetic makeup.
- D. Pain perception is the same in all people.
Correct Answer: A
Rationale: Pain expression and perception vary individually due to cultural, personal, and situational factors, countering the stereotype. Pain tolerance and perception are not uniform or solely genetic.
Following a total hip replacement, the nurse should position the client in which of the following ways?
- A. Place weights alongside of the affected extremity to keep the extremity from rotating.
- B. Elevate both feet on two pillows.
- C. Keep the lower extremities adducted by use of an immobilization binder around both legs.
- D. Keep the extremity in slight abduction using an abduction splint or pillows placed between the thighs.
Correct Answer: D
Rationale: Slight abduction prevents dislocation by maintaining proper hip alignment.
The nurse identifies a medication error involving a client with a colostomy. Which action should the nurse take first?
- A. Administer the correct medication.
- B. Notify the physician and complete an incident report.
- C. Monitor the client for adverse effects.
- D. Educate the client about the error.
Correct Answer: B
Rationale: Notifying the physician and completing an incident report is the first action after a medication error to ensure proper follow-up and documentation. Administering medication, monitoring, or educating the client are secondary steps after reporting. CN: Safety and infection control; CL: Synthesize
As part of the client's discharge planning after a subtotal gastrectomy, the nurse has identified Imbalanced nutrition: Less than body requirements as a major nursing diagnosis. To help the client meet nutritional goals at home, the nurse should develop a plan of care that includes which of the following interventions?
- A. Instruct the client to increase the amount eaten at each meal.
- B. Encourage the client to eat smaller amounts more frequently.
- C. Explain that if vomiting occurs after a meal, nothing more should be eaten that day.
- D. Inform the client that bland foods are typically less nutritional and should be used minimally.
Correct Answer: B
Rationale: Smaller, frequent meals help prevent dumping syndrome and ensure adequate nutrition post-gastrectomy. Large meals, fasting after vomiting, or avoiding bland foods are not appropriate.