Nokea
The nurse is teaching a client with a new diagnosis of atrial fibrillation about diltiazem (Cardizem). Which of the following statements by the client indicates a need for further teaching?
- A. I should check my pulse before taking this medication.
- B. I should report swelling in my legs to my doctor.
- C. I should take this medication with grapefruit juice.
- D. I should avoid driving if I feel dizzy.
Correct Answer: C
Rationale: Taking diltiazem with grapefruit juice is incorrect, as it increases drug levels, risking toxicity. Options A, B, and D are correct: pulse monitoring detects bradycardia, leg swelling may indicate heart failure, and avoiding driving with dizziness prevents accidents.
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A 3-year-old girl with complaints of dysuria. The physician orders a catheterization to obtain a urine specimen.
The nurse should
- A. describe the procedure to the child in short, concrete terms while talking calmly.
- B. let the child play with the equipment during the procedure.
- C. involve the girl's older sister in explaining the procedure.
- D. show the child a diagram of the urinary system.
Correct Answer: A
Rationale: Strategy: All answers are implementations. Determine the outcome of each answer choice. Is it desired? (1) correct-children this age need simple explanations (2) might contaminate the equipment, must be a sterile procedure (3) not likely to listen to sister (4) not appropriate for this age
A child is admitted in sickle cell crisis. Which factor in the child's history is most likely related to the onset of the crisis?
- A. The child just completed final exams at school.
- B. The child ran a marathon yesterday.
- C. The child recently had a cold.
- D. The child received a hepatitis A immunization two weeks ago.
Correct Answer: C
Rationale: Infections, like a recent cold, can trigger sickle cell crisis by increasing oxygen demand and causing dehydration, leading to sickling of red blood cells.
The nurse is administering digoxin to a 6-month-old infant. Which finding would cause the nurse to withhold the medication and notify the charge nurse or the physician?
- A. Apical heart rate of 85
- B. Appears lethargic
- C. Circumoral cyanosis
- D. Respiratory rate of 38
Correct Answer: A
Rationale: An apical heart rate below 100 in infants indicates bradycardia, a contraindication for digoxin due to toxicity risk, requiring withholding and reporting.
The nurse is caring for a client with heart failure.
- A. Which symptom indicates worsening heart failure in a client?
- B. Weight gain of 2 pounds in 24 hours.
- C. Decreased blood pressure.
- D. Clear lung sounds bilaterally.
- E. Improved exercise tolerance.
Correct Answer: A
Rationale: A weight gain of 2 pounds in 24 hours indicates fluid retention, a sign of worsening heart failure. Decreased blood pressure may occur but is less specific, clear lung sounds suggest stability, and improved exercise tolerance indicates improvement.
A client with chronic obstructive pulmonary disease (COPD) and a history of coronary artery disease is receiving aminophylline, 25 mg/hour. Which one of the following findings by the nurse would require immediate intervention?
- A. Decreased blood pressure and respirations
- B. Flushing and headache
- C. Restlessness and palpitations
- D. Increased heart rate and blood pressure
Correct Answer: C
Rationale: Restlessness and palpitations. Side effects of Aminophylline include restlessness and palpitations.