Nokea
The nurse is preparing a client with type 2 diabetes for a CT with contrast to evaluate diverticulitis with a possible mass. Which of the following medications on the client's medication list would be of concern to the nurse?
- A. fish oil
- B. warfarin (Coumadin)
- C. fluoxetine (Prozac)
- D. metformin (Glucophage)
Correct Answer: D
Rationale: Metformin should be held before and after contrast CT due to the risk of lactic acidosis if renal function is impaired by contrast dye.
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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.
Which laboratory finding would indicate a 62-year-old male client is at risk for ventricular dysrhythmia?
- A. magnesium 0.8 mmEq/L
- B. potassium 4.2 mmol/L
- C. creatinine 1.3 mg/dL
- D. total calcium 2.8 mmol/L
Correct Answer: A
Rationale: Low magnesium (0.8 mEq/L; normal 1.5-2.5 mEq/L) increases the risk of ventricular dysrhythmias. Other values are within normal ranges.
A client who just delivered is concerned about her neonate's Apgar scores of 7 at 1 minute and 8 at 5 minutes. She has been told a score lower than 9 is associated with learning disabilities. Which response is best?
- A. Your infant is fine. Don't worry.
- B. Apgar scores indicate a need for extra medical care at birth. Your baby's score of 7 is fine.
- C. There are many good special education programs available I can recommend.
- D. I'll ask the physician to speak with you.
Correct Answer: B
Rationale: Apgar scores of 7 and 8 are within normal limits, indicating no immediate need for extra care, and this response addresses the mother's concern accurately without dismissing it.
The nurse caring for the child with a large meningomylocele is aware that the priority care for this client is to:
- A. Cover the defect with a moist, sterile saline gauze
- B. Place the infant in a supine position
- C. Feed the infant slowly
- D. Measure the intake and output
Correct Answer: A
Rationale: Moist, sterile gauze prevents infection and drying of the meningomyelocele defect.
A client admitted with hepatic encephalopathy continues to attempt ambulation without assistance despite repeated instruction. Which intervention should the nurse take to promote safety?
- A. administer Xanax 6 mg PO
- B. apply a vest restraint device
- C. request a family member stay with the client around the clock
- D. move the client closer to the nurses' station
Correct Answer: D
Rationale: Moving the client closer to the nurses’ station allows frequent monitoring, promoting safety without restraints or sedation, which are less appropriate.