Nokea
The nurse reinforces discharge teaching for the parent of a child newly prescribed methylphenidate for attention-deficit hyperactivity disorder. The nurse advises the parent that the child might experience which side effects?
- A. Decreased blood pressure and growth delays
- B. Heart palpitations and weight gain
- C. Loss of appetite and restlessness
- D. Trouble sleeping and a dry cough
Correct Answer: C
Rationale: Methylphenidate commonly causes loss of appetite and restlessness . Hypotension , palpitations/weight gain , and cough are less typical.
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After obtaining a nutritional assessment of an elderly client, the nurse determines that the client's diet lacks sufficient protein. Which foods represent low-cost sources of protein?
- A. Potatoes and beef
- B. Peas and beans
- C. Tomatoes and beets
- D. Pork and rice
Correct Answer: B
Rationale: Peas and beans are low-cost, high-protein foods. Beef and pork are expensive, and potatoes, tomatoes, beets, and rice are low in protein.
Laboratory reference ranges
WBCs
5000–10,000/mm3
(5–10 × 109/L)
Hemoglobin
Male: 14.0–18.0 g/dL
(140–180 g/L)
Female: 12.0–16.0 g/dL
(120–160 g/L)
Which client incident would be classified as an adverse event that requires an incident/event/irregular occurrence/variance report? Select all that apply.
- A. Client admitted with WBC count of 28,000 mm3 (28.0 x 109/L) and dies from sepsis
- B. Client receives 1 mg morphine instead of prescribed 0.5 mg morphine
- C. Client refuses pneumonia vaccination and contracts pneumonia
- D. Nurse did not report client's new hemoglobin result of 6.0 g/dL (60 g/L) to oncoming nurse
- E. Provider was not notified of client's positive blood culture results
Correct Answer: B,D,E
Rationale: Medication error , failure to report hemoglobin , and failure to notify about blood culture are reportable adverse events. Sepsis death and vaccine refusal are not necessarily preventable errors.
The nurse is caring for an acutely ill 10 year-old client. Which of the following assessment findings would require the nurses immediate attention?
- A. Rapid bounding pulse
- B. Temperature of 101.3 degrees Fahrenheit (38.5 degrees Celsius)
- C. Profuse diaphoresis
- D. Slow, irregular respirations
Correct Answer: D
Rationale: Slow, irregular respirations. A slow and irregular respiratory rate is a sign of fatigue in an acutely ill child. Fatigue can rapidly lead to respiratory arrest.
An elderly client is severely dehydrated. Which is the best way to assess the effectiveness of fluid restoration therapy?
- A. Assess the client's skin turgor every shift.
- B. Record weights daily.
- C. Ask the client if she is thirsty.
- D. Record all intake.
Correct Answer: B
Rationale: Daily weights provide an objective measure of fluid restoration, as 1 kg approximates 1 L of fluid. Skin turgor is less reliable in elders, thirst is subjective, and intake alone doesn't confirm absorption.
A client with chronic pancreatitis is receiving Pancreatin. Which of the following observations is most indicative that the drug treatment is having the desired effect?
- A. The client's appetite is improved.
- B. The client's weight loss is greater than 10 pounds.
- C. The client's stools contain less fat and occur with less frequency.
- D. The client's tissue bruises less easily.
Correct Answer: C
Rationale: Pancreatin replaces pancreatic enzymes, aiding fat digestion. Reduced fat in stools and less frequent bowel movements indicate effective treatment. Appetite improvement is secondary, weight loss is undesirable, and bruising is unrelated.