Nokea
The nurse is reviewing medication orders for his clients. Which order would necessitate contacting the health care provider?
- A. Paxil (paroxetine) 20 mg PO daily for a 57-year-old client with social anxiety disorder
- B. Phenergan (promethazine hydrochloride) 12.5 mg PR q12h prn for a child with Reye's syndrome
- C. Diflucan (fluconazole) 150 mg x 1 dose PO for a 24-year-old client with vaginal candidiasis
- D. Lopressor (metoprolol tartrate) 50 mg PO daily for a 48-year-old client with hypertension
Correct Answer: B
Rationale: Promethazine is contraindicated in children with Reye’s syndrome due to the risk of worsening neurological symptoms. Other orders are appropriate.
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The nurse is assessing a client with a closed reduction of a fractured femur. Which finding should the nurse report to the physician?
- A. Chest pain and shortness of breath.
- B. Ecchymosis on the side of the injured leg.
- C. Oral temperature of 99.2°F.
- D. Complaints of level two pain on a scale of five.
Correct Answer: A
Rationale: Chest pain and shortness of breath may indicate a pulmonary embolism, a serious complication requiring immediate reporting.
If the nurse is unable to elicit the deep tendon reflexes of the patella, the nurse should ask the client to:
- A. Pull against the palms
- B. Grimace the facial muscles
- C. Cross the legs at the ankles
- D. Perform Valsalva maneuver
Correct Answer: A
Rationale: Pulling against the palms enhances reflex response by increasing muscle tone, aiding in eliciting the patellar reflex.
A client elects to have epidural anesthesia to relieve the discomfort of labor. Following the initiation of epidural anesthesia, the nurse should give priority to:
- A. Checking for cervical dilation
- B. Placing the client in a supine position
- C. Checking the client's blood pressure
- D. Obtaining a fetal heart rate
Correct Answer: C
Rationale: Epidural anesthesia can cause hypotension, making blood pressure monitoring a priority.
A client with obsessive compulsive personality disorder annoys his coworkers with his rigid-perfectionistic attitude and his preoccupation with trivial details. An important nursing intervention for this client would be:
- A. Helping the client develop a plan for changing his behavior
- B. Contracting with him for the time he spends on a task
- C. Avoiding a discussion of his annoying behavior because it will only make him worse
- D. Encouraging him to set a time schedule and deadlines for himself
Correct Answer: D
Rationale: Setting a time schedule helps the client manage perfectionistic tendencies by structuring tasks, reducing preoccupation with trivial details.
The client presents to the emergency room with a hyphema. Which action by the nurse would be best?
- A. Elevate the head of the bed and apply ice to the eye
- B. Place the client in a supine position and apply heat to the knee
- C. Insert a Foley catheter and measure the intake and output
- D. Perform a vaginal exam and check for a discharge
Correct Answer: A
Rationale: Elevating the head and applying ice reduces intraocular pressure and swelling in hyphema, a bleed in the eye.