Nokea
The nurse reviews the ECG of a client. Which prescribed medication should the nurse suspect as the cause of the ECG findings?
- A. Captopril
- B. Carvedilol
- C. Glipizide
- D. Levothyroxine
Correct Answer: D
Rationale: Levothyroxine (D) can cause arrhythmias, which may be reflected in ECG changes. Captopril (A), Carvedilol (B), and Glipizide (C) are less likely to cause significant ECG alterations.
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Which finding by the nurse suggests that the mother is not giving the toddler iron supplements as ordered?
- A. The child has pale skin.
- B. There is light brown stool in the diaper.
- C. The child takes a nap every day.
- D. The child has ecchymotic areas on her legs.
Correct Answer: B
Rationale: Iron supplements typically cause dark or black stools; light brown stools suggest non-compliance with iron supplementation.
A nurse is reinforcing fall-prevention teaching to the spouse of a 78-year-old client who recently experienced a stroke. What suggestion by the nurse is most effective in preventing falls?
- A. Ensure that your spouse rises slowly after sitting or lying down.'
- B. Purchase a walker for your spouse to use when walking around the home'
- C. Remove all area rugs and install grab bars in the bathroom'
- D. Schedule a home health aide to monitor your spouse while you are away.'
Correct Answer: C
Rationale: Removing rugs and installing grab bars (C) directly addresses environmental hazards, the most effective fall prevention strategy. Rising slowly (A), using a walker (B), or hiring an aide (D) are helpful but less comprehensive.
A client with borderline personality disorder says to the nurse, 'You're the only one I trust around here. The others don't know what they are doing and they don't care about anyone except themselves. I only want to talk with you.' What is the priority nursing action?
- A. Assign different staff members to care for the client each day
- B. Assign the client's stated preferred nurse to care for the client
- C. Reassure the client that all staff members are competent in their jobs
- D. Reinforce unit guidelines and appropriate boundaries with the client
Correct Answer: D
Rationale: Reinforcing boundaries (D) addresses splitting behavior and maintains therapeutic relationships. Rotating staff (A), assigning the preferred nurse (B), or reassuring competence (C) may reinforce manipulation.
When giving an intramuscular injection to an infant. Which of the following sites is preferred?
- A. Ventrogluteal region
- B. Deltoid
- C. Vastus lateralis
- D. Dorsogluteal region
Correct Answer: C
Rationale: Vastus lateralis is the ideal choice for infants.
The nurse is talking with a client with major depressive disorder who has been taking paroxetine for the past 3 weeks. Which of the following statements by the client would require immediate follow-up?
- A. I have had a decreased appetite lately.'
- B. I still feel depressed even though I have more energy.'
- C. I sometimes have difficulty falling asleep at night.'
- D. I have had a decreased interest in sexual activity recently.'
Correct Answer: B
Rationale: Persistent depression with increased energy (B) may indicate rising suicide risk, requiring immediate follow-up. Appetite (A), sleep (C), and libido (D) changes are common side effects.