Nokea
The nurse learns that an Orthodox Jewish client has not started taking recently prescribed diltiazem extended-release capsules. The client states 'I cannot take the medication in this form.' What is the nurse's first action?
- A. Ask the health care provider to prescribe a different calcium channel blocker
- B. Consult with the pharmacist to see if an alternate form of the drug is available
- C. Open the capsule and sprinkle the medication in a cup of applesauce
- D. Warn the client about the dangers of uncontrolled hypertension
Correct Answer: B
Rationale: The client may object to gelatin in capsules due to dietary restrictions. Consulting the pharmacist for an alternative form respects the client's beliefs.
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A 4-year old is scheduled for a routine tonsillectomy. Which of the following lab findings should be reported to the doctor?
- A. A hemoglobin of $12 \mathrm{gm}$
- B. A platelet count of $200,000 \mathrm{cu} \mathrm{mm}$
- C. A white cell count of $16,000 \mathrm{cu} \mathrm{mm}$
- D. A urine specific gravity of 1.010
Correct Answer: C
Rationale: A white cell count of 16,000 is elevated, suggesting infection, which must be reported before surgery. Hemoglobin , platelets , and urine specific gravity are normal.
An anxious parent of a 4 year-old consults the nurse for guidance in how to answer the child's question, 'Where do babies come from?' What is the nurse's best response to the parent?
- A. When a child asks a question, give a simple answer.
- B. Children ask many questions, but are not looking for answers.
- C. This question indicates interest in sexual development.
- D. Full and detailed answers should be given to all questions.
Correct Answer: A
Rationale: When a child asks a question, give a simple answer. Honesty is important, but answers should be simple and age-appropriate, providing only the information the child is ready to understand.
The nurse is caring for a woman who is admitted for a hysterectomy. The woman does not speak English. No staff members speak the client's language. Which approach by the nurse would be most appropriate when communicating with the client about her care before and after the surgery?
- A. Ask the woman's 8-year-old daughter who speaks English to interpret.
- B. Draw pictures and gesture when speaking to the client.
- C. Speak very slowly when giving the client instructions.
- D. Request an interpreter from social services.
Correct Answer: D
Rationale: The nurse should request an interpreter from social services to ensure accurate communication. Using a child to interpret is inappropriate due to medical terminology and privacy concerns. Pictures, gestures, or slow speech in English are insufficient for surgical care discussions.
A client with methicillin-resistant Staphylococcus aureus (MRSA) bacteremia has been receiving IV vancomycin for the last 3 days. Which blood test trend is most important for the nurse to review when preparing to administer this medication?
- A. Blood cultures
- B. Creatinine levels
- C. Magnesium levels
- D. White blood cell (WBC) count
Correct Answer: B
Rationale: Vancomycin can cause nephrotoxicity, so monitoring creatinine levels is critical to assess kidney function.
An adult is admitted with a possible detached retina. Which findings would the nurse expect during the admission assessment?
- A. The client says, 'My eye is very painful.'
- B. The client complains of a blank area in the visual field.
- C. The client says he sees halos around lights.
- D. The client says he cannot see anything that is not right in front of him.
Correct Answer: B
Rationale: Detached retina causes a visual field defect, like a blank area or curtain, due to retinal separation, unlike pain, halos (glaucoma), or tunnel vision.