Nokea
The nurse is teaching a client with a new diagnosis of heart failure about carvedilol (Coreg). Which of the following instructions should the nurse include?
- A. Take the medication at bedtime.
- B. Report dizziness or lightheadedness.
- C. Stop the medication if symptoms improve.
- D. Avoid checking pulse rate.
Correct Answer: B
Rationale: Dizziness or lightheadedness may indicate hypotension, a carvedilol side effect, requiring reporting. Options A, C, and D are incorrect.
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An elderly client with a fractured hip is placed in Buck's traction. The primary purpose for Buck's traction for this client is:
- A. To decrease muscle spasms
- B. To prevent the need for surgery
- C. To alleviate the pain associated with the fracture
- D. To prevent bleeding associated with hip fractures
Correct Answer: A
Rationale: Buck's traction immobilizes the hip to reduce muscle spasms, which can worsen pain and misalignment. It does not prevent surgery or bleeding and is not primarily for pain relief.
A child who received meperidine (Demerol) IM one hour ago.
The nurse knows that which of the following is the BEST assessment indicating relief from abdominal pain for a child who received meperidine (Demerol) IM one hour ago?
- A. The child states that his pain has gone away.
- B. The child's heart rate has changed from 80 to 95.
- C. The child sleeps except when receiving nursing care.
- D. Results from the incentive spirometer have improved.
Correct Answer: D
Rationale: Strategy: Think about what the words mean. (1) contains correct information, but is not a priority; child could deny pain out of fear of getting another injection (2) indicates discomfort, anxiety (3) indicates a need to decrease the amount of medication (4) correct-when pain is decreased, child will be better able to breathe deeply and improve the outcome of use of the incentive spirometer
During the second session of individual therapy, a client sits quietly with arms folded and eyes cast down.
Which of the following statements by the nurse is BEST?
- A. What is the weather like outside?
- B. Do you not want to talk with me today?
- C. Are you cold sitting here?
- D. You seem to be feeling sad today.
Correct Answer: D
Rationale: Strategy: 'BEST' indicates that this is a priority question. Remember therapeutic communication. (1) is used to get client comfortable, but would not help to focus on what is important (2) focusing on client's difficulty speaking may make him defensive and block communication (3) concrete questions will encourage client to give yes/no answers, factual answers may block communication of feelings (4) correct-reflection allows client to verbalize feelings
After abdominal surgery, a client is admitted from the recovery room with intravenous fluid infusing at 100 cc/h. One hour later, the nurse finds the clamp wide open and notes that the client has received 850 cc.
The nurse would be MOST concerned by which of the following?
- A. A CVP reading of 12 and bradycardia.
- B. Tachycardia and hypotension.
- C. Dyspnea and oliguria.
- D. Rales and tachycardia.
Correct Answer: D
Rationale: Strategy: 'MOST concerned' indicates a complication. (1) CVP is normal, and bradycardia is incorrect (2) does not contain information relevant to fluid overload (3) does not contain information relevant to fluid overload (4) correct-indicate cardiovascular fluid overload
A 2-month-old boy with a temperature of $102°F (39°C) is brought to the emergency department by his mother.
- A. What should the nurse’s response be based on regarding a fever in a 2-month-old one week after a DPT immunization?
- B. If a fever does occur in a child after a DPT, it usually occurs within the first 2 hours.
- C. An elevated temperature is very rarely seen in a child after a DPT immunization.
- D. If there is a fever after a DPT, it is usually low-grade and appears within the first 48 hours.
- E. The child’s high fever is a direct response to the DPT immunization and should be treated.
Correct Answer: C
Rationale: A low-grade fever within 24-48 hours is a common response to DPT immunization. A high fever (102°F) one week later is unlikely related to the immunization and should be reported to a physician for evaluation, possibly indicating another cause.