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The nurse is talking to a client with a newly diagnosed seizure disorder who has a prescription for levetiracetam. Which of the following statements by the client would require follow-up?
- A. I can begin driving my car again after I have been taking this medication for 2 weeks
- B. I need to contact my health care provider if I develop a rash while taking this medication
- C. I should report any new or increased anxiety I experience while taking this medication
- D. I understand that drowsiness is an adverse effect of this medication that may improve over time.
Correct Answer: A
Rationale: Driving restrictions for seizure disorders typically last 6-12 months seizure-free, not 2 weeks, posing a safety risk. Reporting rashes and anxiety are correct due to potential side effects of levetiracetam.
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A client with a C3 spinal cord injury has a headache and nausea. The client’s blood pressure is 170/100 mm Hg. How should the nurse respond initially?
- A. Administer PRN analgesic medication
- B. Administer PRN antihypertensive medication
- C. Lower the head of the bed
- D. Palpate the client’s bladder
Correct Answer: D
Rationale: Headache, nausea, and hypertension in a C3 injury suggest autonomic dysreflexia, often triggered by bladder distension. Palpating the bladder identifies and addresses the cause. Medications and bed positioning are secondary.
The nurse is evaluating the effectiveness of the medication regimen for a client with chronic kidney disease who is receiving sodium polystyrene sulfonate. It would indicate that the medication regimen has been effective if the client’s most recent laboratory test results indicate
- A. an increase in the serum calcium level
- B. an increase in the serum creatinine level
- C. a decrease in the serum potassium level
- D. a decrease in the serum phosphate level
Correct Answer: C
Rationale: Sodium polystyrene sulfonate treats hyperkalemia in chronic kidney disease by exchanging sodium for potassium in the gut, so a decreased potassium level indicates effectiveness. Calcium levels are not directly affected, and rising creatinine indicates worsening kidney function.
The charge nurse is reviewing events that staff nurses experienced during the shift. Which events require an incident/occurrence report to be completed? Select all that apply.
- A. Client determined brain dead was taken off life support
- B. Client with alcohol intoxication physically assaulted a nurse
- C. Serum troponin level was prescribed but never obtained
- D. Staff nurse did not present for work and did not notify management
- E. Visitor fell and refused care in the emergency department
Correct Answer: B,C,D
Rationale: Assault, missed lab tests, and staff no-show are reportable incidents due to safety, care quality, and staffing issues. Brain death withdrawal follows protocol, and a visitor’s fall with refused care is less reportable.
Which of the following activities demonstrate safe client handling practices? Select all that apply.
- A. 1 person assisting a client who is 8 hours post hip replacement surgery with a position change
- B. 1 person using a gait belt while transferring a partial weight-bearing client from the bed to a chair
- C. 2 people repositioning a client who is comatose and has been on the left side for 2 hours
- D. 3 people pulling up in bed a client who weighs 331 lb (150 kg)
Correct Answer: B,C,D
Rationale: Using a gait belt, two people for a comatose client, and three for a heavy client ensure safety and prevent injury. One person for a recent hip replacement risks falls or dislocation due to limited mobility.
Damage to the VIII cranial nerve results in:
- A. Air conduction loss
- B. Sensorineural loss
- C. Mixed hearing disorders
- D. Tinnitus
Correct Answer: B
Rationale: The VIII cranial nerve (vestibulocochlear) is responsible for hearing and balance; damage causes sensorineural hearing loss, affecting the inner ear or nerve pathways.