Nokea
The nurse is preparing a community education program about preventing hepatitis B infection. Which of the following would be appropriate to incorporate into the teaching plan?
- A. Hepatitis B is relatively uncommon among college students.
- B. Frequent ingestion of alcohol can predispose an individual to development of hepatitis B.
- C. Good personal hygiene habits are most effective at preventing the spread of hepatitis B.
- D. The use of a condom is advised for sexual intercourse.
Correct Answer: D
Rationale: Condom use (D) prevents hepatitis B transmission via sexual contact. Hepatitis B is not uncommon in college students (A). Alcohol (B) is unrelated to hepatitis B transmission. Hygiene (C) is less effective than barrier protection.
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The client with an ileal conduit will be using a reusable appliance at home. The nurse should teach the client to clean the appliance routinely with the client to clean the appliance routinely.
- A. Baking soda.
- B. Soap.
- C. Hydrogen peroxide.
- D. Alcohol.
Correct Answer: B
Rationale: Soap is safe and effective for cleaning reusable ileal conduit appliances, removing residue without damaging the appliance or irritating the skin.
A male client who has been taking warfarin (Coumadin) has been admitted with severe acute rectal bleeding and the following laboratory results: International Normalized Ratio (INR), 8; hemoglobin, 11 g/dL; and hematocrit, 33%. Which of the following physician orders should the nurse expect to implement initially? Select all that apply.
- A. Administer I.V. dextrose 5% in 0.45% normal saline solution.
- B. Schedule client for a sigmoidoscopy in the morning.
- C. Give 1 unit fresh frozen plasma (FFP).
- D. Administer vitamin K (AquaMEPHYTON) 2.5 mg.
- E. Begin giving polyethylene glycol-electrolyte solution (GoLYTELY) in preparation for sigmoidoscopy.
- F. Administer Fleet enema.
Correct Answer: C,D
Rationale: An INR of 8 indicates excessive anticoagulation from warfarin, causing severe bleeding. Initial management includes administering fresh frozen plasma (FFP) to replace clotting factors and vitamin K to reverse warfarin's effects. Dextrose/saline, sigmoidoscopy preparation, and enemas are not immediate priorities.
A client with thyrotoxicosis says to the nurse, 'I am so irritable. I am having problems at work because I lose my temper very easily.' Which of the following responses by the nurse would give the client the most accurate explanation of her behavior?
- A. Your behavior is caused by your not following the medical regimen.'
- B. Your behavior is caused by the effects of the disease on your thyroid.'
- C. Your behavior is caused by your not accepting your diagnosis.'
- D. Your behavior is caused by the effects of the disease on your emotional stability.'
Correct Answer: B
Rationale: Thyrotoxicosis, due to excess thyroid hormone, increases metabolism and can affect the nervous system, leading to irritability and emotional lability. This explains the client's behavior as a direct result of the disease's impact on thyroid function.
The nurse is to administer Polycillin (ampicillin) 500 mg orally to a client with a ruptured appendix. The nurse checks the capsule in the client's medication box which is located inside of the client's room. The dosage of the medication is not labeled, but the nurse recognizes the color and shape of the capsule. The nurse should next:
- A. Administer the medication to maintain blood levels of the drug.
- B. Ask another registered nurse to verify that the capsule is ampicillin.
- C. Contact the pharmacy to bring a properly labeled medication.
- D. Adjust the unit manager to report the problem.
Correct Answer: C
Rationale: Contacting the pharmacy to bring a properly labeled medication ensures safe administration, as recognizing the capsule's color and shape is insufficient for verification. Administering without confirmation or relying on another nurse risks error, and reporting to the manager delays care. CN: Safety and infection control; CL: Synthesize
The nurse has calculated a low PaO2/FIO2 (P/F) ratio <150 for a client with acute respiratory distress syndrome (ARDS). The nurse should place the client in which position to improve oxygenation, ventilation distribution, and drainage of secretions?
- A. Supine.
- B. Semi-Fowler's.
- C. Lateral side.
- D. Prone.
Correct Answer: D
Rationale: Prone positioning in ARDS with a low P/F ratio (<150) improves oxygenation, ventilation distribution, and secretion drainage by recruiting dependent lung regions. Other positions are less effective.