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 nurse is explaining the effects of cocaine abuse to a pregnant client. Which of the following must the nurse understand as a basis for teaching?
- A. Cocaine use can cause fetal growth retardation
- B. The drug has been linked to neural tube defects
- C. Newborn withdrawal generally occurs immediately after birth
- D. Breast feeding promotes positive parenting behaviors
Correct Answer: A
Rationale: Cocaine is vasoconstrictive, and this effect in the placental vessels causes fetal growth retardation.
The nurse is caring for a client with HIV. The nurse understands that which of the following are true regarding transmission-based precautions? Select all that apply.
- A. Donning an N95 respiratory mask decreases the risk of transmitting HIV
- B. Gown, gloves, and face shield are necessary for every client encounter
- C. Neutropenic precautions are implemented based on laboratory results
- D. The client's urine is a bodily fluid that can transmit HIV
- E. The nurse should perform hand hygiene before and after providing client care
Correct Answer: C,D,E
Rationale: Neutropenic precautions depend on lab results (e.g., low white blood cell count). Urine can transmit HIV if blood is present. Hand hygiene is standard for all encounters. N95 masks are for airborne diseases, not HIV. Full PPE isn't needed unless splashing of bodily fluids is likely.
The nurse is talking with the spouse of a client who is eligible for hospice care. The spouse states, 'I do not know if I can make this decision. What would you do?' Which of the following responses would be appropriate for the nurse to make?
- A. These decisions are challenging. Tell me about your spouse's beliefs regarding end-of-life care.
- B. You seem overwhelmed. I will ask the chaplain to speak with you about available options.
- C. I find it helpful to investigate all options. I will get you a pamphlet about hospice services.
- D. I had to make a similar decision when my spouse was ill. Do what feels best for you.
Correct Answer: A
Rationale: The nurse should remain neutral and facilitate discussion about the client's values and preferences, helping the spouse make an informed decision without personal bias or directing to other resources prematurely.
An adult is admitted with Guillain-Barré syndrome. On day 3 of hospitalization, the client's muscle weakness worsens, and he is no longer able to stand with support. He is also having difficulty swallowing and talking. The priority in the nursing care plan at this time is to prevent which problem?
- A. Aspiration pneumonia
- B. Decubitus ulcers
- C. Bladder distention
- D. Hypertensive crisis
Correct Answer: A
Rationale: Difficulty swallowing increases aspiration risk, making aspiration pneumonia the priority. Other complications are secondary in this acute phase.
The nurse is caring for a client at 21 weeks gestation with reports of occasional, bothersome heartburn (pyrosis). Which of the following lifestyle changes should the nurse recommend? Select all that apply.
- A. Avoid intake of dairy products
- B. Drink large amounts of fluid with meals
- C. Eat several small meals each day
- D. Eliminate fried, fatty foods
- E. Lie down on the left side after meals
Correct Answer: C,D
Rationale: Small, frequent meals reduce stomach acid reflux, and avoiding fatty foods decreases acid production. Dairy can neutralize acid, large fluid intake with meals distends the stomach, and lying down post-meal worsens reflux.