Nokea
The nurse is monitoring a client’s EKG strip and notes coupled premature ventricular contractions greater than 10 per minute. The nurse should expect to administer which of the following?
- A. Atropine sulfate (Atropine) IV.
- B. Isoproterenol (Isuprel) IV.
- C. Verapamil (Calan) IV.
- D. Lidocaine hydrochloride (Xylocaine) IV.
Correct Answer: D
Rationale: Lidocaine is the drug of choice for frequent premature ventricular contractions (PVC) occurring in excess of 6-10 per minute; for coupled PVCs or for a consecutive series of PVCs that may result in ventricular tachycardia
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Which assignment should not be performed by the nursing assistant?
- A. Feeding the client
- B. Bathing the client
- C. Obtaining a stool
- D. Administering a fleet enema
Correct Answer: D
Rationale: Administering an enema is an invasive procedure requiring clinical judgment, which is beyond the scope of a nursing assistant's responsibilities.
A client scheduled for a carotid endarterectomy requires insertion of an intra-arterial blood pressure-monitoring device. The nurse plans to perform the Allen test. Which observation indicates patency of the ulnar artery?
- A. Blanching of the hand on compression and release of the ulnar artery
- B. Muscular twitching of the bicep muscle with use of a tourniquet at the wrist
- C. Hand turning pink after the nurse releases the pressure on the ulnar artery
- D. Flexion of the wrist when tapping the ulnar artery with a reflex hammer
Correct Answer: C
Rationale: The Allen test assesses collateral circulation. The hand turning pink after releasing ulnar artery pressure indicates patency, ensuring adequate blood flow if the radial artery is cannulated.
A client with acute alcohol intoxication is being treated for hypomagnesemia. During assessment of the client, the nurse would expect to find:
- A. Bradycardia
- B. Negative Chvostek's sign
- C. Hypertension
- D. Positive Trousseau's sign
Correct Answer: D
Rationale: Hypomagnesemia can cause a positive Trousseau's sign, indicating neuromuscular irritability due to low magnesium levels.
A 19-year-old male was prescribed sertraline (Zoloft) 3 weeks ago for depression. He calls the clinic today and tells the nurse that he has been feeling increasingly anxious and wants to stop taking the medication because it is not working. The best response for the nurse is
- A. You can stop taking the Zoloft, but let's make another appointment with your provider so you can try a different medication.'
- B. Increased anxiety is a normal side effect for the first few weeks of taking this medication. It will take several weeks to determine if it is working. Please keep taking it as prescribed.'
- C. Increased anxiety is not a normal side effect of Zoloft. What day this week can you come to the clinic to discuss this with your provider?'
- D. Try taking half the prescribed dose for the next week and see if that helps the feelings of anxiety.'
Correct Answer: B
Rationale: Increased anxiety is a common early side effect of SSRIs like sertraline, which typically subsides after a few weeks. The therapeutic effect takes 4-6 weeks. Continuing the medication and monitoring is appropriate.
The nurse is assessing a client with suspected meningitis. Which of the following findings would the nurse expect?
- A. Positive Kernig’s sign.
- B. Hypothermia.
- C. Soft, non-tender neck.
- D. Decreased level of consciousness.
Correct Answer: A
Rationale: positive Kernig’s sign (pain and resistance on leg extension) is a classic finding in meningitis