Nokea
The nurse prepares a client for discharge following a vasectomy. The client asks, 'When can I have sexual intercourse with my wife without using a condom?' What is the best response by the nurse?
- A. Discontinue alternative birth control after at least 5 ejaculations.
- B. There is no need to use alternative birth control following today's procedure.
- C. Use alternative birth control for 6 months following today's procedure.
- D. Use alternative birth control until your physician confirms the absence of sperm in a semen analysis.
Correct Answer: D
Rationale: A vasectomy requires confirmation of azoospermia via semen analysis, typically after 6-12 weeks or 15-20 ejaculations, to ensure sterility. Alternative birth control (C) is needed until this confirmation. Immediate unprotected intercourse (A) risks pregnancy, and 6 months (B) is unnecessarily long.
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Which medication prescriptions should the nurse question? Select all that apply.
- A. Cephalexin for a client with severe allergy to penicillin
- B. Fexofenadine for a client with hives
- C. Ibuprofen for a client with asthma and nasal polyps
- D. Lisinopril for a client with diabetes mellitus
- E. Propranolol for a client with asthma
Correct Answer: A,C,E
Rationale: Cephalexin (A) is contraindicated in penicillin allergy due to cross-reactivity risk. Ibuprofen (C) can trigger bronchospasm in aspirin-exacerbated respiratory disease, common in asthma with nasal polyps. Propranolol (E) is contraindicated in asthma due to beta-blockade causing bronchoconstriction. Fexofenadine (B) is safe for hives, and lisinopril (D) is appropriate for diabetes to protect kidneys.
During the evaluation phase for a client, the nurse should focus on
- A. All finding of physical and psychosocial stressors of the client and in the family
- B. The client's status, progress toward goal achievement, and ongoing re-evaluation
- C. Setting short and long-term goals to insure continuity of care from hospital to home
- D. Select interventions that are measurable and achievable within selected timeframes
Correct Answer: B
Rationale: The client's status, progress toward goal achievement, and ongoing re-evaluation. Evaluation focuses on assessing progress and adjusting the care plan.
A client arrives at the clinic for a follow-up after an emergency department visit the night before. The client sustained an ulnar fracture, and a fiberglass cast was applied. Which of the following teachings related to cast care should the nurse reinforce? Select all that apply.
- A. Contact the clinic if any hot areas or foul odors develop in the cast
- B. Cover the cast with a plastic bag for bathing, and avoid getting the cast wet
- C. Elevate the affected extremity above heart level for the first 48 hours
- D. Expect some numbness and tingling of the fingers during the first week
- E. Use only soft, padded objects to scratch the skin under the cast
Correct Answer: A,B,C,E
Rationale: Hot areas or odors (A) suggest infection, keeping the cast dry (B) prevents skin breakdown, elevation (C) reduces swelling, and soft objects (E) avoid injury. Numbness and tingling (D) are not normal and may indicate nerve compression, requiring immediate reporting.
During an initial prenatal visit, the practical nurse is reviewing the history of a client at 10 weeks gestation. Which finding is a priority to report to the registered nurse?
- A. Client cares for a pet dog and a few outdoor cats
- B. Client has gained 4 lb (1.8 kg) during the pregnancy so far
- C. Client reports a nonodorous, milky white vaginal discharge
- D. Client swims in a pool for exercise three times per week
Correct Answer: A
Rationale: Pet cats (A) pose a toxoplasmosis risk, which can cause fetal harm, requiring immediate education and possible testing. Weight gain (B) is normal, milky discharge (C) is typical in pregnancy, and swimming (D) is safe.
A client with a history of heart disease takes prophylactic aspirin daily. The nurse should monitor which of the following to prevent aspirin toxicity?
- A. Serum potassium
- B. Protein intake
- C. Lactose tolerance
- D. Serum albumin
Correct Answer: D
Rationale: Serum albumin. When highly protein-bound drugs are administered to patients with low serum albumin (protein) levels, excess free (unbound) drug can cause exaggerated and dangerous effects.