Nokea
The nurse is reinforcing teaching with a client who is starting to use a cervical cap for contraception. Which client statement would require follow-up?
- A. I should apply spermicide to the cervical cap before inserting it.
- B. I can insert the cervical cap several hours before I have sexual intercourse.
- C. I should leave the cervical cap in place for at least 24 hours after intercourse.
Correct Answer: C
Rationale: Leaving the cervical cap in for at least 24 hours increases infection risk; it should remain for 6-8 hours post-intercourse. Applying spermicide and inserting hours before intercourse are correct practices for effective use.
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A client with terminal cancer becomes hypoxic and unresponsive. According to the client’s paperwork, the client’s sister is the legal medical power of attorney. Both the client’s spouse and sister are present. Which action by the nurse is appropriate at this time?
- A. Ask the spouse about the client’s wishes
- B. Get directions about care from the client’s sister
- C. Prepare for emergency intubation
- D. Request that the sister provide a living will
Correct Answer: B
Rationale: The sister, as the legal medical power of attorney, is authorized to make healthcare decisions when the client is unresponsive. Consulting the spouse is inappropriate, intubation may not align with the client’s wishes, and a living will is not required as the sister has decision-making authority.
Narrow therapeutic index medications:
- A. are drug formulations with limited pharmacokinetic variability.
- B. have limited value and require no monitoring of blood levels.
- C. have less than a twofold difference in minimum toxic levels and minimum effective concentration in the blood.
- D. have limited potency and side effects.
Correct Answer: C
Rationale: Narrow therapeutic index drugs have a small margin between effective and toxic doses, requiring close monitoring. The other descriptions are inaccurate or irrelevant. Pharmacological Therapies
The nurse is preparing to administer 40 mg of oral furosemide. Prior to administering the medication, the nurse should evaluate which parameters? Select all that apply.
- A. Blood pressure
- B. Blood urea nitrogen
- C. Liver enzymes
- D. Potassium
- E. White blood cell count
Correct Answer: A,D
Rationale: Furosemide can cause hypotension and hypokalemia, so blood pressure and potassium levels must be evaluated. Blood urea nitrogen reflects kidney function but is not critical before administration, and liver enzymes and white blood cell count are unrelated.
A nurse is documenting notes in the client's electronic record after making rounds on assigned clients. Which entry is an appropriate documentation?
- A. Client appears to be sleeping. Eyes closed
- B. Client reports, 'I'm in pain.' Medication provided
- C. Inspiratory wheezes heard in bilateral lower lung fields
- D. Voided x1
Correct Answer: C
Rationale: Inspiratory wheezes in bilateral lower lung fields is a specific, objective finding that accurately describes the client's condition. The other entries are vague, lack detail, or are subjective without supporting data.
A man is being discharged following a vasectomy. Which comment by the client indicates a need for more instruction?
- A. I will wear this scrotal support for the next few days.'
- B. I will continue to use a condom for the next two weeks.'
- C. My wife and I have decided that the four children we have are all we want.'
- D. I will keep the area clean and observe for signs of infection.'
Correct Answer: B
Rationale: Condom use is needed for 6-12 weeks post-vasectomy until azoospermia is confirmed, not just 2 weeks. Scrotal support, family planning, and hygiene are appropriate.