Nokea
The nurse is reviewing the medication profile for a client with chronic obstructive pulmonary disease. Which prescription should the nurse question?
- A. Amlodipine
- B. Codeine
- C. Ipratropium
- D. Methylprednisolone
Correct Answer: B
Rationale: Codeine, an opioid, suppresses cough and respiration, risking respiratory depression in COPD. Amlodipine treats hypertension, ipratropium relieves bronchospasm, and methylprednisolone reduces inflammation, all appropriate for COPD.
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A 79-year-old client asks the nurse if she needs any shots. She reports having had 'all the usual shots when I was younger.' Which immunization is most important for this person to receive?
- A. DPT
- B. MMR
- C. Pneumovax
- D. HiB
Correct Answer: C
Rationale: Pneumovax is critical for adults over 65 to prevent pneumococcal pneumonia, a significant risk in the elderly.
A father brings his 17-year-old son to a walk-in clinic. The client reports a sudden severe headache. He has a temperature of 104°F and a purple rash. What is the best action for the nurse at this time?
- A. Prepare for a throat culture
- B. Schedule him for an appointment later in the day
- C. Isolate and alert the physician immediately
- D. Obtain a urine specimen
Correct Answer: C
Rationale: Symptoms suggest meningococcal meningitis, a medical emergency requiring isolation and immediate physician notification.
A client with suspected foot osteomyelitis is scheduled for an MRI. Which client findings should the nurse report before the test? Select all that apply.
- A. Cardiac pacemaker
- B. Colostomy
- C. Retained metal foreign body in eye
- D. Total hip replacement
- E. Transdermal testosterone patch
Correct Answer: A,C,D
Rationale: Pacemakers, metal in the eye, and hip replacements pose MRI risks due to magnetic interference or heating. Colostomies and transdermal patches are not contraindicated for MRI.
The client taking a bronchodilator tells the nurse that he is going to begin a smoking cessation program when he is discharged. The nurse should tell the client to notify the doctor if his smoking pattern changes because he will:
- A. Need his medication dosage adjusted
- B. Require an increase in antitussive medication
- C. No longer need annual influenza immunization
- D. Not derive as much benefit from inhaler use
Correct Answer: A
Rationale: Changes in smoking patterns should be discussed with the physician because they have an impact on the amount of medication needed. Answer B is incorrect because clients with COPD are placed on expectorants, not antitussives. Answer C is incorrect because an annual influenza vaccine is recommended for all those with lung disease. Answer D is incorrect because benefits from inhaler use should be increased when the client stops smoking.
A laboring woman prefers to lie in the supine position during labor. The nurse teaches her that this is not a good position for which reason?
- A. It will cause more back pressure.
- B. Her baby will not come down well into the pelvis.
- C. Her blood pressure may drop and cause the baby's heart rate to drop.
- D. Contractions will be too close together, not giving her a rest.
Correct Answer: C
Rationale: Supine position can compress the vena cava, causing maternal hypotension and reduced fetal perfusion, leading to fetal heart rate drops.