Nokea
The nurse is preparing to administer Synthroid, a thyroid hormone replacement, to the client diagnosed with hypothyroidism. Which assessment data would indicate the client is receiving too much medication?
- A. Bradypnea and weight gain.
- B. Lethargy and hypotension.
- C. Irritability and tachycardia.
- D. Normothermia and constipation.
Correct Answer: C
Rationale: Excess Synthroid causes hyperthyroidism symptoms like irritability and tachycardia. Bradypnea, lethargy, or constipation suggest hypothyroidism.
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The nurse is caring for a child immediately after surgical correction of a ventricular septal defect. Which of the following nursing assessments should be a priority?
- A. Blanch nail beds for color and refill
- B. Assess for post-operative arrhythmias
- C. Auscultate for pulmonary congestion
- D. Monitor equality of peripheral pulses
Correct Answer: B
Rationale: Assess for post-operative arrhythmias. The atrioventricular bundle (bundle of His), a part of the electrical conduction system of the heart, extends from the atrioventricular node along each side of the interventricular septum and then divides into right and left bundle branches. Surgical repair of a ventricular septal defect consists of a purse-string approach or a patch sewn over the opening.
An adult client is on call for the operating room. The preoperative medication order is for meperidine HCl (Demerol) 100 mg IM and atropine 0.4 mg IM. The operating room calls at 11:00 A.M. and requests that the client be medicated. The nurse notes that the client last received meperidine for pain at 10:00 A.M. What is the most appropriate action for the nurse to take?
- A. Give the preoperative medication as ordered
- B. Give half the dose of meperidine and all of the atropine
- C. Check with the anesthesiologist before administering the medication
- D. Withhold both the meperidine and the atropine
Correct Answer: C
Rationale: Recent meperidine administration increases the risk of respiratory depression. Consulting the anesthesiologist ensures safe dosing.
An elderly adult is scheduled for repair of a fractured femur this morning. The nurse goes in to administer the preoperative medication of Demerol 75 mg and atropine 0.4 mg IM. The client asks the nurse if he should take his eye drops before surgery. What is the best initial response for the nurse to make?
- A. You can take them when you get back from surgery.
- B. I'll give them to you now.
- C. Let me check with your physician.
- D. What kind of eye drops are you taking?
Correct Answer: D
Rationale: Knowing the type of eye drops (e.g., for glaucoma or infection) determines if they are critical pre-surgery, guiding further action.
An adult client who has been taking furosemide (Lasix) 40 mg PO every day for several weeks is complaining of muscle weakness and lethargy. Which test will be of greatest value in assessing the client's condition?
- A. Serum electrolytes
- B. Urinalysis
- C. Serum creatinine
- D. Five-hour glucose tolerance test
Correct Answer: A
Rationale: Furosemide can cause hypokalemia, leading to muscle weakness and lethargy; serum electrolytes assess potassium levels.
The nurse is evaluating the client's home medications and notes the client with angina is taking an antidepressant. Which intervention should the nurse implement because the client is taking this medication?
- A. Ask the client if there is a plan for suicide.
- B. Assess the client's depression on a 1-to-10 scale.
- C. Explain this medication cannot be taken because of the angina.
- D. Request a referral to the hospital psychologist.
Correct Answer: A
Rationale: Antidepressants in angina patients raise suicide risk concerns; assessing for a plan is the priority to ensure safety.