Nokea
The nurse is talking with a client who has a new prescription for misoprostol to prevent gastric ulcers. Which of the following statements by the client would require follow-up?
- A. I will take this medication with meals and at bedtime.
- B. I plan to use a reliable form of birth control while taking this medication.
- C. I can take this medication with an antacid to prevent an upset stomach.
- D. I should notify my health care provider if I develop black, tarry stools while taking this medication.
Correct Answer: C
Rationale: Taking misoprostol with antacids (C) reduces its efficacy and requires follow-up. Taking with meals (A), using contraception (B), and reporting black stools (D) are correct.
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The nurse is caring for a client who had a portable water seal chest drainage system inserted today. Which observation indicates that the client's drainage system is working properly?
- A. There are no bubbles in the water seal bottle.
- B. The suction control chamber has continuous bubbles.
- C. There are bubbles in the drainage chamber.
- D. There is no fluctuation in the fluid in the water seal chamber.
Correct Answer: A
Rationale: No bubbles in the water seal bottle indicates a stable system without air leaks, confirming proper function post-insertion.
The nurse is caring for a hospice client with advanced heart failure who is having trouble breathing. Which comfort intervention should the nurse implement first?
- A. Administer PRN albuterol by nebulizer
- B. Assist with guided imagery to relieve anxiety
- C. Elevate the head of the bed
- D. Give PRN sublingual morphine
Correct Answer: C
Rationale: Elevating the head of the bed (C) is the first non-pharmacologic intervention to ease breathing in heart failure by reducing pulmonary congestion. Albuterol (A) is for bronchospasm, imagery (B) is secondary, and morphine (D) is for severe distress.
A client is admitted with a diagnosis of hepatitis B. In reviewing the initial laboratory results, the nurse would expect to find elevation in which of the following values?
- A. Blood urea nitrogen
- B. Acid phosphatase
- C. Bilirubin
- D. Sedimentation rate
Correct Answer: C
Rationale: Bilirubin. Hepatitis B causes liver dysfunction, leading to elevated bilirubin levels.
An adult comes to the physician's office with a history of headache yesterday and today and pain in the back. The nurse observes a horizontal band of pustular rash on the back extending from the spine to midline in the front. The client describes it as very painful. What would the nurse expect to be prescribed for this client?
- A. Antiviral
- B. Antibiotics
- C. Topical hydrocortisone
- D. Benadryl
Correct Answer: A
Rationale: The painful, unilateral, dermatomal pustular rash suggests herpes zoster (shingles), treated with antivirals like acyclovir.
A 62-year-old client admitted to the telemetry unit after an acute myocardial infarction 3 days ago reports that the left calf is very tender and warm to the touch. Which nursing intervention is the priority?
- A. Asking the client how long the leg has been tender and warm
- B. Checking the electrocardiogram for ectopic beats
- C. Obtaining vital signs, including pulse oximetry
- D. Performing a neurovascular check on the lower extremities
Correct Answer: D
Rationale: Tenderness and warmth suggest deep vein thrombosis, so a neurovascular check (D) is the priority to assess for complications. History (A), ECG (B), and vitals (C) are secondary.