Nokea
The nurse is reviewing new medication prescriptions for a client with pneumonia and chronic kidney disease. The nurse should clarify the prescription for
- A. acetaminophen
- B. levofloxacin
- C. epoetin alfa
- D. ibuprofen
Correct Answer: B
Rationale: Levofloxacin is primarily excreted by the kidneys, and its use in clients with chronic kidney disease may require dose adjustments or alternative antibiotics to prevent toxicity due to impaired clearance.
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The family of a frail elderly man who is bedridden asks the nurse what they can do to prevent bedsores. Which response by the nurse is best?
- A. Get him out of bed at least once a day.'
- B. Turn him every two hours.'
- C. Rub his buttocks and apply lotion several times a day.'
- D. Change the sheets every day.'
Correct Answer: B
Rationale: Turning every two hours relieves pressure on bony prominences, preventing pressure ulcers. Getting out of bed may be infeasible, and rubbing or sheet changes are less effective.
The nurse is experiencing repeated unwanted sexual advances from a health care provider (HCP). Which of the following actions should the nurse take? Select all that apply.
- A. Seek emotional support from a trusted source.
- B. Consult the facility's sexual harassment policy.
- C. Report the behavior to the supervisor immediately.
- D. Document each occurrence according to facility policy.
- E. Confront the HCP outside the workplace about the behavior.
Correct Answer: A,B,C,D
Rationale: Seeking support aids coping, reviewing policy clarifies procedures, reporting to a supervisor initiates formal action, and documentation provides evidence. Confronting outside work risks escalation and is unsafe.
During a home visit, the community health nurse observes bruises in various stages of healing on the extremities and torso of an elderly client. The client explains that the bruises are from bumping into furniture and the well in the wheelchair. What is the priority nursing action?
- A. Ask the client to explain the bruises on the torso
- B. Assess the client's general hygiene and nutritional status
- C. Report the bruises to the client's health care provider (HCP)
- D. Talk to the client's child about the injuries
Correct Answer: C
Rationale: Multiple bruises in various stages raise suspicion for elder abuse, requiring reporting to the HCP for investigation. Further questioning may cause distress, and hygiene/nutrition assessments are secondary. Discussing with family risks alerting potential abusers.
The nurse is reinforcing education to a group of clients who are pregnant or planning pregnancy. Which of the following client statements about alcohol use in pregnancy indicate a need for further education? Select all that apply.
- A. As long as I don't binge drink, an occasional glass of wine is fine.
- B. I drank alcohol heavily before realizing I was pregnant, so there is no benefit to quitting now.
- C. If I drink alcohol, my baby may have withdrawal after birth but no permanent damage.
- D. It is important to stop drinking while I am trying to conceive.
- E. Third-trimester alcohol use is less harmful because the baby is fully developed.
Correct Answer: A,B,C,E
Rationale: No amount of alcohol is safe during pregnancy, as it can cause fetal alcohol spectrum disorders. Quitting at any point reduces harm. Alcohol can cause permanent damage, not just withdrawal. Third-trimester exposure still risks brain development. Stopping preconception is correct.
A client with myxedema should be prescribed which diet?
- A. A diet low in fats
- B. A diet high in carbohydrates
- C. A diet high in sugars
- D. A diet low in salt
Correct Answer: B
Rationale: Myxedema (hypothyroidism) slows metabolism, so a high-carbohydrate diet provides energy to support metabolic needs.