Nokea
The nurse is reviewing new medication prescriptions for a client with asthma and nasal polyps. The nurse should clarify the prescription for
- A. ibuprofen
- B. vitamin D
- C. albuterol
- D. montelukast
Correct Answer: A
Rationale: Ibuprofen should be clarified in asthma with nasal polyps due to risk of aspirin-exacerbated respiratory disease. Vitamin D , albuterol , and montelukast are safe.
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The registered nurse and practical nurse are conducting a workshop on contraceptive methods for a group of outpatient clients. Which instructions should the nurses include when discussing combined estrogen-progestin oral contraceptives? Select all that apply.
- A. Consult the health care provider (HCP) if you experience leg pain or swelling
- B. Discontinue contraceptives if you experience spotting between menses
- C. Do not smoke while taking combined contraceptives
- D. Immediately report any breast tenderness to the HCP
- E. Seek immediate medical treatment if you experience vision loss
Correct Answer: A,C,E
Rationale: For combined oral contraceptives: report leg pain/swelling for possible DVT; avoid smoking due to increased cardiovascular risk; and seek treatment for vision loss indicating possible stroke. Spotting is common and breast tenderness is not urgent.
Which statement, if made by the client, indicates a possible problem?
- A. I have a bowel movement every other day.'
- B. My stools recently are black.'
- C. Sometimes I have to strain when I go to the bathroom.'
- D. I usually have three stools a day.'
Correct Answer: B
Rationale: Black stools may indicate gastrointestinal bleeding, a serious concern requiring evaluation. Other statements reflect normal variations or minor issues.
Laboratory reference ranges
Hemoglobin
Male: 14.0–18.0 g/dL
(140–180 g/L)
Female: 12.0–16.0 g/dL
(120–160 g/L)
WBC
5000–10,000/mm³
(5–10 × 10⁹/L)
The nurse is collecting data from a client with acute diverticulitis. Which of the following findings would be essential to follow up?
- A. abdominal pain has progressed to the left upper quadrant
- B. hemoglobin of 11.2 g/dL (112 g/L)
- C. lying on side with knees drawn up to abdomen and trunk flexed
- D. WBC count of 12,000/mm³ (12 x 10â¹/L)
Correct Answer: A
Rationale: Pain progressing to the left upper quadrant in diverticulitis is concerning for complications like perforation or abscess, requiring follow-up. Mild anemia and flexed positioning are common, and a moderately elevated WBC is expected in acute inflammation.
The nurse is talking with the parents of a 7-year-old client with newly diagnosed type 1 diabetes mellitus. Which of the following statements by the parents would indicate effective coping?
- A. Our child may not be able to participate in any sporting activities'
- B. Our whole family is willing to make sacrifices for our child's health.'
- C. We will make separate meals for our child to accommodate any dietary needs.'
- D. We are working to manage this condition so that our child can have an independent life.'
Correct Answer: D
Rationale: Aiming for the child's independence in managing diabetes indicates effective coping by focusing on empowerment. Assuming no sports or separate meals is overly restrictive, and vague sacrifices lack specificity.
The nurse is caring for a client who is in the first stage of labor and is reporting intense back pain with contractions. The fetal position is determined to be right occiput posterior. Which of the following actions should the nurse take?
- A. Place the client in the supine position
- B. Apply counterpressure to the client's sacrum during contractions
- C. Encourage the client to remain in bed
- D. Request that the nurse anesthetist administer epidural anesthesia
Correct Answer: B
Rationale: For back pain in labor with a right occiput posterior position, applying counterpressure to the sacrum relieves discomfort. Supine position worsens pain, bed rest limits mobility, and epidural is not the first intervention.