Nokea
The nurse is discharging a client with asthma who has a prescription for zafirlukast (Accolate). Which comment by the client would indicate a need for further teaching?
- A. I should take this medication with meals.'
- B. I need to report flulike symptoms to my doctor.'
- C. My doctor might order liver tests while I'm on this drug.'
- D. If I'm already having an asthma attack, this drug will not stop it.'
Correct Answer: A
Rationale: Zafirlukast should be taken on an empty stomach for better absorption. The other statements are correct: flulike symptoms and liver monitoring are relevant, and zafirlukast is not a rescue medication.
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A 51-year-old client received a kidney transplant. Which of the following signs and symptoms indicates possible rejection of the kidney? Select all that apply.
- A. increased urine output
- B. increase in blood pressure
- C. weight gain
- D. pain in lower back
- E. decreased creatinine
Correct Answer: B,C,D
Rationale: Kidney rejection causes hypertension (B), fluid retention (weight gain, C), and graft pain (D). Decreased urine output (not increased) and elevated creatinine (not decreased) are typical.
The nurse is caring for a client following the removal of a central line catheter when the client suddenly develops dyspnea and complains of substernal chest pain. The client is noticeably confused and fearful. Based on the client's symptoms, the nurse should suspect which complication of central line use?
- A. Myocardial infarction
- B. Air embolus
- C. Intrathoracic bleeding
- D. Vagal response
Correct Answer: B
Rationale: Sudden dyspnea, chest pain, and confusion post-central line removal suggest an air embolus, a serious complication requiring immediate intervention.
The physician has ordered a minimal-bacteria diet for a client with neutropenia. The client should be taught to avoid eating:
- A. Fruits
- B. Salt
- C. Pepper
- D. Ketchup
Correct Answer: A
Rationale: Raw fruits may harbor bacteria, posing an infection risk for a neutropenic client on a minimal-bacteria diet.
An electrical fire occurs in a client's room shortly after the client returns from the recovery room after repair of a hip fracture with insertion of a prosthesis. What is the best method of removing the client from the room?
- A. Place the client in a wheelchair.
- B. Transfer the client to a gurney.
- C. Move the bed with the client on it.
- D. Do a two-person carry.
Correct Answer: C
Rationale: Moving the bed with the client on it (C) is the safest and fastest method to evacuate a post-surgical client with limited mobility during an emergency like a fire. Other methods (A, B, D) risk injury or delay.
A client is being discharged with an implantable cardioverter-defibrillator (ICD), and the nurse is educating the client about home management. The client asks what he should do if the ICD fires one time but he has no other symptoms. Which of the following is the best advice?
- A. Call 9-1-1.
- B. Go to the emergency department when recovered from the firing.
- C. Resume normal activities.
- D. Lie down and rest and report the event to the physician by telephone.
Correct Answer: D
Rationale: A single ICD firing without symptoms should be reported to the physician (D) for evaluation. Calling 9-1-1 (A) or going to the ED (B) is unnecessary, and resuming activities (C) may be premature.