Nokea
The nurse is talking with a client who has a new prescription for metronidazole. Which of the following statements by the client would require follow up?
- A. I can continue to drink a glass of wine with dinner while I am taking this medication'
- B. I might experience a metallic taste in my mouth while I am taking this medication'
- C. I should not be concerned if my urine turns a dark color while taking this medication'
- D. I will immediately contact my health care provider if I experience a rash or skin peeling.'
Correct Answer: A
Rationale: Drinking alcohol while taking metronidazole can cause a disulfiram-like reaction, requiring follow-up. Metallic taste and dark urine are common side effects, and reporting rash or peeling is appropriate.
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Which client condition is concerning and requires further nursing observation and intervention? Select all that apply.
- A. Client with asthma exacerbation and blood pressure is 150/90 mm Hg
- B. Client with spinal cord injury and blood pressure is 50/60 mm Hg
- C. Client with coronary artery disease on metoprolol, pulse is 62/min
- D. Elderly client with black stool; pulse is 112/min
- E. Neonate crying inconsolably at feeding time; pulse is 160/min
Correct Answer: B,D,E
Rationale: Concerning conditions include: spinal cord injury with hypotension suggesting neurogenic shock; black stool and tachycardia indicating possible GI bleeding; and inconsolable neonate with tachycardia suggesting distress. Asthma with hypertension and stable pulse on metoprolol are less urgent.
The nurse aus.Concurrent with the above question, the nurse auscultates crackles and diminished breath sounds in lung bases. Which action is appropriate at this time?
- A. Administer an inhaled bronchodilator
- B. Check marked insertion depth of the tube
- C. Request a prescription for a diuretic
- D. Start the client on incentive spirometry
Correct Answer: C
Rationale: Crackles and diminished breath sounds in the lung bases postpartum suggest fluid overload or pulmonary edema, possibly due to prolonged labor or excessive IV fluids. Requesting a diuretic is appropriate to reduce fluid overload. Bronchodilators are for bronchospasm, checking tube depth is irrelevant without an endotracheal tube, and incentive spirometry is less urgent.
A client is scheduled for a percutaneous transluminal coronary angioplasty (PTCA). The nurse knows that a PTCA is the
- A. Surgical repair of a diseased coronary artery
- B. Placement of an automatic internal cardiac defibrillator
- C. Procedure that compresses plaque against the wall of the diseased coronary artery to improve blood flow
- D. Non-invasive radiographic examination of the heart
Correct Answer: C
Rationale: PTCA is performed to improve coronary artery blood flow in a diseased artery. It is performed during a cardiac catheterization.
The physician has ordered a sterile urine specimen to be collected from a client who has a Foley catheter. To obtain a sterile urine specimen, the nurse should:
- A. Use a luer lock syringe and withdraw from the bulb port.
- B. Disconnect the catheter from the drainage bag.
- C. Open the urine bag and remove the specimen.
- D. Use a syringe and withdraw from the catheter port.
Correct Answer: D
Rationale: Withdrawing from the catheter port with a syringe ensures a sterile specimen. Other methods risk contamination.
An older adult client is to receive an antibiotic, gentamicin. What diagnostic finding indicates the client may have difficulty excreting the medication?
- A. High gastric pH
- B. High serum creatinine
- C. Low serum albumin
- D. Low serum blood urea nitrogen
Correct Answer: B
Rationale: An elevated serum creatinine indicates reduced renal function. Reduced renal function will delay the excretion of many medications.