Nokea
The nurse is performing discharge teaching to a client who is on isoniazid (INH). Which diet selection would let the nurse know that the teaching has been ineffective?
- A. Tuna casserole
- B. Ham salad sandwich
- C. Baked potato
- D. Broiled beef roast
Correct Answer: A
Rationale: Isoniazid can interact with tyramine-rich foods like tuna, causing adverse effects (e.g., hypertension). Selecting tuna casserole indicates ineffective teaching. The other foods are safe.
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A client is to receive 1,000 mL of potassium chloride in 5% dextrose injection (D5W) intravenously over 3 hours and 20 minutes using a drop factor of 15 drops/mL. What is the required flow rate (drops) per minute? Record your answer using a whole number.
Correct Answer: 75
Rationale: To calculate the flow rate in drops per minute, use the formula: (Total volume X Drop factor)/ Total time in minutes. The total volume is 1,000 mL, the drop factor is 15 drops/mL, and the time is 3 hours 20 minutes = 200 minutes. Thus, (1,000 X 15)/ 200 = 15,000/ 200 = 75 drops/minute.
While caring for a client with cervical cancer, the nurse notes that the radioactive implant is lying in the bed. The nurse should:
- A. Place the implant in a biohazard bag and return it to the lab
- B. Give the client a pair of gloves and ask her to reinsert the implant
- C. Use tongs to pick up the implant and return it to a lead-lined container
- D. Discard the implant in the commode and double-flush
Correct Answer: C
Rationale: Radioactive implants must be handled with tongs and placed in a lead-lined container to minimize radiation exposure, per safety protocols.
The nurse is assigning staff for the day. Which client should be assigned to the nursing assistant?
- A. A 5-month-old with bronchiolitis
- B. A 10-year-old 2-day post-appendectomy
- C. A 2-year-old with periorbital cellulitis
- D. A 1-year-old with a fractured tibia
Correct Answer: B
Rationale: A stable post-appendectomy patient requires basic care, suitable for a nursing assistant.
The client admitted with angina is given a prescription for nitroglycerine. The client should be instructed to:
- A. Replenish his supply every 3 months
- B. Take one every 15 minutes if pain occurs
- C. Leave the medication in the brown bottle
- D. Crush the medication and take with water
Correct Answer: C
Rationale: Nitroglycerin should be stored in its original brown bottle to protect it from light and maintain potency.
The floor nurse sees a new order in a client's chart for levothyroxine (Synthroid) 125 mcg PO every day. The pharmacy sends up Synthroid 0.1 mg tablets. How many tablets should the nurse administer? Calculate and fill in the blank.
Correct Answer: 1.25
Rationale: 125 mcg = 0.125 mg. 0.125 mg ÷ 0.1 mg/tablet = 1.25 tablets.