Nokea
The nurse is teaching a client about prescribed metronidazole. Which of the following statements by the client indicates effective teaching?
- A. I should not drink alcohol while I’m taking metronidazole.
- B. It is okay for me to be in the sun while I’m taking this medicine.
- C. I should take the medicine until my stomach stops hurting, then stop.
- D. I should take the medicine on an empty stomach.
Correct Answer: A
Rationale: Metronidazole can cause a disulfiram-like reaction with alcohol, so avoiding alcohol is correct. Sun exposure is not a major concern, stopping early risks incomplete treatment, and metronidazole can be taken with food.
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The following scenario applies to the next 1 items
The nurse in the emergency department is caring for a 19-year-old male client.
Item 1 of 1
Nurses' Notes
0555: Client presents with abdominal pain, nausea, and some vomiting. The client's parents report that his symptoms started two nights ago and originated in the right lower quadrant. Overnight, his symptoms significantly intensified, and he developed a fever and chills. On assessment, the client's skin is hot and pale. Lung sounds are clear, and apical pulse is regular. Bowel sounds are absent in all quadrants. Abdomen is distended and rigid with guarding. Generalized abdominal pain was reported and rated 8/10 on the Numerical Rating Scale. He states that his abdominal pain increases with cough or movement and is relieved by bending the right hip. Vital signs: T 104°F (40°C), P 116, RR 21, BP 110/76, pulse oximetry reading 96% on room air. He has a medical history of iron deficiency anemia.
Laboratory Results
white blood cell (WBC) count: 21,000 mm3 [5,000–10,000/mm3]
hemoglobin: 13.9 g/dL [14–18 g/dL]
hematocrit: 41.7% [42%–52%]
Complete the diagram by dragging from the choices below to specify what condition the client is most likely experiencing, two (2) actions the nurse should take to address that condition, and two (2) parameters the nurse should monitor to assess the client's progress.
- A. Insert a peripheral venous access device (VAD), obtain a stool specimen for culture and sensitivity (C & S), prepare the client for surgery, request an order for a clear liquid diet.
- B. Peritonitis, diverticulitis, appendicitis, gastroenteritis.
- C. Lung sounds, pulse, temperature, hemoglobin and hematocrit.
Correct Answer: B: Appendicitis; A: Insert a peripheral VAD, prepare the client for surgery; C: Temperature, pulse
Rationale: The clinical presentation (right lower quadrant pain, fever, leukocytosis, rigid abdomen) strongly suggests appendicitis (B). Inserting a VAD and preparing for surgery (A) are critical for anticipated appendectomy. Monitoring temperature and pulse (C) tracks infection and hemodynamic status.
The nurse is performing teaching for a client scheduled for gastric bypass surgery. Which client statement requires follow-up by the nurse?
- A. Once I am home, I can advance my diet as tolerated.
- B. I will have to take a multivitamin after this surgery.
- C. I will be encouraged to perform leg exercises while I am in bed.
- D. My weight may increase if I do not change my eating habits.
Correct Answer: A
Rationale: Advancing the diet as tolerated (A) is incorrect; gastric bypass patients follow a strict, staged diet progression to prevent complications. Other statements (B, C, D) are accurate.
A nurse is caring for a client who is admitted to the emergency department with an acetaminophen overdose. The primary action of N-acetylcysteine in the treatment of acetaminophen overdose is
- A. Inhibition of hepatic enzymes
- B. Binding to acetaminophen metabolites
- C. Enhancement of renal excretion
- D. Stimulation of hepatic regeneration
Correct Answer: B
Rationale: N-acetylcysteine replenishes glutathione, which binds to toxic acetaminophen metabolites, preventing liver damage. It does not inhibit enzymes, enhance renal excretion, or stimulate regeneration directly.
The nurse is caring for a client who recently had a partial gastrectomy. Which of the following medications should the nurse anticipate that the primary health care provider (PHCP) will order?
- A. Cyanocobalamin
- B. Metoclopramide
- C. Sucralfate
- D. Hydroxyzine
Correct Answer: A
Rationale: Cyanocobalamin (A) is anticipated post-gastrectomy to prevent vitamin B12 deficiency due to reduced intrinsic factor production.
The nurse is assessing a client with suspected acute cholecystitis. Which of the following findings would support a diagnosis of acute cholecystitis?
- A. Decreased serum bilirubin
- B. Increased high density lipoprotein cholesterol (HDL-C)
- C. Decreased serum aminotransferases
- D. Increased white blood cell count (WBC)
Correct Answer: D
Rationale: An increased WBC count (D) indicates inflammation or infection, supporting a diagnosis of acute cholecystitis. Bilirubin (A) and aminotransferases (C) may rise, and HDL-C (B) is unrelated.