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The nurse is teaching a client with a new diagnosis of osteoarthritis about celecoxib (Celebrex). Which of the following instructions should the nurse include?
- A. Take the medication with grapefruit juice
- B. Report any black, tarry stools
- C. Stop the medication if pain decreases
- D. Avoid regular joint exams
Correct Answer: B
Rationale: Black, tarry stools indicate gastroinTest inal bleeding, a serious celecoxib side effect. Options A, C, and D are incorrect: grapefruit juice is irrelevant, stopping the medication may not be advised, and exams are needed.
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Which of these clients would the nurse monitor for the complication of C. difficile diarrhea?
- A. An adolescent taking medications for acne
- B. An elderly client living in a retirement center taking prednisone
- C. A young adult in the second trimester of pregnancy
- D. A middle-aged client receiving radiation for throat cancer
Correct Answer: D
Rationale: A middle-aged client receiving radiation for throat cancer. Radiation therapy, particularly to the abdomen or pelvis, can disrupt the gut microbiota and increase the risk of C. difficile infection, especially if the client is also receiving antibiotics or has a weakened immune system.
The nurse is caring for a client with a history of atrial fibrillation who is receiving warfarin (Coumadin) 5 mg PO daily. Which of the following laboratory results should the nurse report immediately?
- A. INR of 3.5.
- B. PTT of 40 seconds.
- C. Platelet count of 200,000/mm^3.
- D. Hemoglobin of 13 g/dL.
Correct Answer: A
Rationale: An INR of 3.5 is above the therapeutic range (2.0–3.0), increasing bleeding risk. Options B, C, and D are normal.
The nurse is caring for a client who had a transurethral resection of the prostate yesterday.
- A. What is the most concerning symptom in a client one day post-transurethral resection of the prostate?
- B. Urine output of 150 cc over 8 hours.
- C. Bladder spasms and urgency.
- D. Bright red urine with small clots.
- E. Burning on urination.
Correct Answer: A
Rationale: A urine output of 150 cc over 8 hours is critically low, indicating possible obstruction, bleeding, or renal impairment, requiring immediate intervention. Bladder spasms, bright red urine with clots, and burning are expected post-procedure but should be monitored.
The nurse is to perform a routine blood glucose check on a diabetic client before administering insulin. Which action is correct?
- A. Puncture the end of the thumb in the middle of the fleshy part.
- B. Puncture the end of the finger on the side.
- C. Draw blood from the antecubital vein in the arm.
- D. Puncture the finger and collect the blood in a vial.
Correct Answer: B
Rationale: Puncturing the finger's side avoids nerve-rich areas, ensuring accurate and less painful glucose testing.
The parents of an infant ask the nurse in the physician's office what diseases the DPT shot protects against. What should the nurse include when replying?
- A. Diarrhea, polio, and typhoid
- B. Diphtheria, whooping cough, and tetanus
- C. Diarrhea, pertussis, and typhus
- D. Diphtheria, paralysis, and tetany
Correct Answer: B
Rationale: The DPT (DTaP) vaccine protects against diphtheria, pertussis (whooping cough), and tetanus. The other options include incorrect diseases.