Nokea
The nurse should tell the client to do which of the following when teaching the client about taking oral glucocorticoids?
- A. Take your medication with a full glass of water.'
- B. Take your medication on an empty stomach.'
- C. Take your medication at bedtime to increase absorption.'
- D. Take your medication with meals or with an antacid.'
Correct Answer: D
Rationale: Taking glucocorticoids with meals or an antacid reduces gastrointestinal irritation, a common side effect.
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The nurse is caring for a client in skeletal traction for a femoral fracture. Which assessment should be prioritized?
- A. Skin integrity at pin sites.
- B. Room temperature control.
- C. Frequency of bowel movements.
- D. Client's emotional status.
Correct Answer: A
Rationale: Pin site infections are a common complication in skeletal traction, requiring prioritized assessment.
A 60-year-old male client comes into the emergency department with a complaint of crushing substernal chest pain that radiates to his shoulder and left arm. The admitting diagnosis is acute myocardial infarction (MI). Immediate admission orders include oxygen by nasal cannula at 4 L/minute, blood work, a chest radiograph, a 12-lead electrocardiogram (ECG), and 2 mg of morphine sulfate given I.V. The nurse should first:
- A. Administer the morphine.
- B. Obtain a 12-lead ECG.
- C. Obtain the blood work.
- D. Order the chest radiograph.
Correct Answer: A
Rationale: Administering morphine first relieves pain, reducing myocardial oxygen demand and stabilizing the client. ECG and blood work follow to confirm diagnosis, but pain management is the priority.
A client receiving chemotherapy for metastatic colorectal cancer has had 2 days of vomiting. Assessment findings include: irregular pulse of 120, blood pressure 88/48, respiratory rate of 14, serum potassium of 2.9 mEq/L, and arterial blood gas€”pH 7.46, PCO‚‚ 45, PO‚‚ 95, bicarbonate level 29 mEq/L. Which of the following interventions is appropriate for the nurse to administer to the client?
- A. Oxygen at 4 L per nasal cannula.
- B. Potassium 40 mEq PO now.
- C. 5% Dextrose in 0.45% Normal Saline with KCl 40 mEq/L at 125 mL/hour.
- D. NaHCO‚ƒ 75 mEq IV.
Correct Answer: C
Rationale: Hypokalemia (2.9 mEq/L) and hypotension (88/48) due to vomiting require I.V. fluid and potassium replacement (D5 0.45% NS with KCl) to correct electrolyte imbalance and dehydration. The alkalosis (pH 7.46) does not require bicarbonate, and oral potassium is unsafe with vomiting.
When administering I.V. midazolam hydrochloride (Versed) the nurse should?
- A. Assess the blood pressure.
- B. Monitor the pulse oximeter.
- C. Encourage slow, deep breaths.
- D. Explain relaxation techniques.
Correct Answer: B
Rationale: Midazolam can cause respiratory depression, so monitoring the pulse oximeter is essential to ensure adequate oxygenation during administration.
A client with a new ileostomy is concerned about returning to work. Which advice should the nurse provide to support the client's transition?
- A. Wear loose clothing to conceal the pouch.
- B. Avoid all physical activity for 6 months.
- C. Change the pouch daily regardless of output.
- D. Limit fluid intake to reduce output.
Correct Answer: A
Rationale: Wearing loose clothing helps conceal the ileostomy pouch, boosting the client's confidence at work. Avoiding activity is unnecessary, daily pouch changes are not required unless needed, and limiting fluids risks dehydration. CN: Psychosocial adaptation; CL: Synthesize