Nokea
The nurse is reinforcing discharge teaching for the parents of a 1-year-old with a newly diagnosed cow's milk allergy. Which nutrients normally provided by milk should be obtained from other sources? Select all that apply.
- A. Calcium
- B. Fiber
- C. Iron
- D. Vitamin D
- E. Vitamin K
Correct Answer: A,D
Rationale: Cow's milk is a primary source of calcium and vitamin D, which must be supplemented in a milk allergy. Fiber, iron, and vitamin K are not primarily provided by milk and are obtained from other dietary sources.
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The nurse in the emergency department is caring for a client who is experiencing an acute exacerbation of asthma. Which of the following medications should the nurse expect to administer?
- A. Nebulized albuterol
- B. PO montelukast sodium
- C. IV methylprednisolone succinate
- D. Inhaled ipratropium
- E. Inhaled salmeterol
Correct Answer: A
Rationale: Nebulized albuterol, a short-acting beta-agonist, rapidly relieves bronchospasm in acute asthma exacerbations. Montelukast is for maintenance, methylprednisolone is slower-acting, ipratropium is secondary, and salmeterol is long-acting, not for acute relief.
The nurse is caring for several clients who have ostomies. Which client will have the most wellformed drainage? The client whose colostomy is in the:
- A. ileum.
- B. ascending colon.
- C. transverse colon.
- D. descending colon.
Correct Answer: D
Rationale: The descending colon absorbs more water, producing well-formed, solid stool compared to the ileum (liquid), ascending colon (semi-liquid), or transverse colon (semi-formed).
The nurse is caring for a client who had a transsphenoidal hypophysectomy and developed diabetes insipidus. Which of the following findings would the nurse expect to observe? Select all that apply.
- A. excessive thirst
- B. increased urine output
- C. increased serum osmolality
- D. decreased serum sodium level
- E. increased urine specific gravity
Correct Answer: A,B,C
Rationale: Diabetes insipidus results from antidiuretic hormone deficiency, causing excessive thirst, increased dilute urine output, and increased serum osmolality due to water loss. Serum sodium may increase, not decrease, and urine specific gravity is low due to dilute urine.
The physician orders the antibiotics ampicillin (Omnipen) and gentamicin (Garamycin) for a newly admitted client with an infection. The nurse should:
- A. administer both medications simultaneously.
- B. give the medications sequentially, and flush well between them.
- C. ask the physician or pharmacy which medication to give first and how long to wait before giving the other drug.
- D. start one medication now and begin the other medication in 2-4 hours.
Correct Answer: B
Rationale: Ampicillin and gentamicin are pH-incompatible, so they must be given sequentially with thorough flushing to prevent precipitation in the IV line. Simultaneous or delayed administration is inappropriate. Pharmacological Therapies
The nurse is preparing 7:00 AM medications for a client with a urinary tract infection and a history of heart failure and type 2 diabetes. Based on the information from the medical and medication records, which prescription should the nurse question before administering?
- A. Furosemide
- B. Glipizide
- C. Levofloxacin
- D. Potassium chloride
Correct Answer: A
Rationale: Furosemide in heart failure requires careful monitoring of fluid status and electrolytes, especially early in the day, to avoid exacerbating dehydration or hypotension. Glipizide, levofloxacin, and potassium chloride are appropriate for diabetes, UTI, and potential hypokalemia, respectively.