Nokea
The nurse is preparing to administer a dose of ondansetron (Zofran) for nausea. Which route is most appropriate for rapid onset?
- A. Oral
- B. Intramuscular
- C. Intravenous
- D. Sublingual
Correct Answer: C
Rationale: Intravenous ondansetron provides the fastest onset for nausea relief, ideal in acute settings. Oral and sublingual routes are slower, and IM is less common.
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Prenatal clients are routinely monitored for early signs of pregnancy-induced hypertension (PIH). For the prenatal client, which of the following blood pressure changes from baseline would be most significant for the nurse to report as indicative of PIH?
- A. 136/88 to 144/93
- B. 132/78 to 124/76
- C. 114/70 to 140/88
- D. 140/90 to 148/98
Correct Answer: C
Rationale: PIH is indicated by a systolic increase of 30 mm Hg or diastolic increase of 15 mm Hg; 114/70 to 140/88 shows a 26 mm Hg systolic and 18 mm Hg diastolic change, most significant for PIH.
The nurse in the emergency room is caring for a client with multiple rib fractures and a pulmonary contusion. Assessment reveals a respiratory rate of 38, a heart rate of 136, and restlessness. Which associated assessment finding would require immediate intervention?
- A. Occasional small amounts of hemoptysis
- B. Midline trachea with wheezing on auscultation
- C. Subcutaneous air and absent breath sounds
- D. Pain when breathing deeply, with rales in the upper lobes
Correct Answer: C
Rationale: Subcutaneous air and absent breath sounds suggest pneumothorax, requiring immediate intervention (e.g., chest tube). Hemoptysis (A), wheezing (B), and pain/rales (D) are concerning but less urgent.
The registered nurse is making shift assignments. Which client should be assigned to the licensed practical nurse (LPN)?
- A. A client who is a diabetic with a foot ulcer
- B. A client with a deep vein thrombosis receiving intravenous heparin
- C. A client being weaned from a tracheostomy
- D. A post-operative cholecystectomy with a T-tube
Correct Answer: A
Rationale: A diabetic with a foot ulcer is stable and suitable for an LPN, who can perform wound care and monitoring. Heparin infusion (B), tracheostomy weaning (C), and T-tube management (D) require RN-level skills due to complexity and risk.
To prevent transmission of bacterial meningitis, the nurse would instruct an infected baby's mother to:
- A. Avoid touching the baby while in the room.
- B. Stay outside of the baby's room.
- C. Wear a gown and gloves and wash her hands before and after leaving the room.
- D. Wear a mask while in the room.
Correct Answer: C
Rationale: The mother should be allowed and encouraged to touch her baby. With care, transmission can be prevented. There is no need for the mother to stay outside the room. Everyone entering the baby's room should take appropriate measures to prevent transmission of pathogens. Wearing a mask will not protect against transmission of pathogens.
The nurse is caring for a client with a history of a myocardial infarction who is receiving Nitroglycerin. The nurse should monitor the client for:
- A. Hypotension
- B. Tachycardia
- C. Hyperglycemia
- D. Fever
Correct Answer: A
Rationale: Nitroglycerin, a vasodilator, commonly causes hypotension due to decreased preload. Tachycardia is possible but secondary, and hyperglycemia/fever are unrelated.