Nokea
The nurse is to administer an iron injection to an adult. How should this be administered?
- A. Subcutaneous in the arm
- B. Intradermal in the forearm
- C. Intramuscular in the deltoid
- D. Z track intramuscular in the gluteal
Correct Answer: D
Rationale: Iron injections are given via Z-track intramuscular in the gluteal muscle to prevent leakage and skin staining, ensuring deep muscle administration.
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An 80-year-old woman is having difficulty sleeping. Which nursing action is most appropriate initially?
- A. Ask the physician for an order for a sleeping medication.
- B. Encourage the client to do mild exercises a half hour before going to bed.
- C. Suggest to the client that she not nap during the day.
- D. Recommend the client drink coffee in the evening.
Correct Answer: C
Rationale: Avoiding daytime naps improves nighttime sleep hygiene, a non-pharmacologic initial approach suitable for an elderly client.
The client is scheduled for a paracentesis. What should the nurse expect to do prior to the procedure?
- A. Insert an indwelling catheter
- B. Have the client void
- C. Keep the client NPO
- D. Administer an enema
Correct Answer: B
Rationale: Having the client void before paracentesis prevents bladder puncture during the procedure. Catheter insertion, NPO status, or enemas are not typically required.
After passing a nasogastric (NG) tube in an adult, the nurse checks for proper placement by doing which of the following?
- A. Injecting air into the NG tube and listening with a stethoscope over the stomach for a 'swoosh'
- B. Putting the end of the NG tube in a glass of water and observing for bubbles
- C. Asking the client if the tube is comfortable
- D. Aspirating contents and checking the pH
Correct Answer: D
Rationale: Aspirating gastric contents and checking pH (typically 1-5 for stomach) is the most reliable method to confirm NG tube placement in the stomach. Air injection is less definitive, water bubbling is unsafe, and comfort does not confirm placement.
The nurse is repairing new prescriptions from the health care provider. Which prescription would require further clarification?
- A. Atorvastatin for hyperlipidemia in a client with angina pectoris
- B. Bupropion for smoking cessation in a client with emphysema
- C. Cyclobenzaprine for muscle spasms in a client with hepatitis
- D. Metronidazole for trichomoniasis in a client with Crohn disease
Correct Answer: C
Rationale: Cyclobenzaprine is contraindicated in hepatic impairment due to hepatitis, as it is metabolized by the liver, requiring clarification. Other prescriptions (A, B, D) are appropriate for the conditions.
The nurse in the emergency department is caring for a client who sustained blunt force head trauma and is experiencing blurry vision. The nurse should suspect the client has sustained injury to the
- A. temporal lobe
- B. occipital lobe
- C. parietal lobe
- D. frontal lobe
Correct Answer: B
Rationale: Blurry vision post-head trauma suggests injury to the occipital lobe , which processes visual information. Temporal , parietal , and frontal lobes manage other functions.