Nokea
A nurse manager is planning an in-service about pain management with opioids for clients who have cancer. Which of the following information should the nurse manager include?
- A. IM administration is recommended if PO opioids are ineffective
- B. Respiratory depression decreases as opioid tolerance develops
- C. Meperidine is the opioid of choice for treating chronic pain
- D. Withhold PRN pain medication for the client who is receiving opioids every 6 hr
Correct Answer: B
Rationale: The correct answer is B because respiratory depression decreases as opioid tolerance develops. Opioid tolerance occurs with prolonged use, leading to a decrease in the side effect of respiratory depression. This information is crucial for healthcare providers managing cancer pain with opioids. Choice A is incorrect because oral administration is preferred over intramuscular for better absorption and convenience. Choice C is incorrect as meperidine is not recommended for chronic pain due to its toxic metabolite. Choice D is incorrect as PRN pain medication should not be withheld for clients on scheduled opioid doses to ensure adequate pain control.
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A nurse is assessing a client who reports taking over-the-counter antacids. Which of the following findings should the nurse identify as a manifestation of hypercalcemia?
- A. Constipation
- B. Decreased urine output
- C. Positive Trousseau's sign
- D. Headache
Correct Answer: A
Rationale: The correct answer is A: Constipation. Hypercalcemia can result from excessive intake of antacids containing calcium carbonate. High levels of calcium in the blood can lead to constipation due to its inhibitory effect on smooth muscle contraction in the intestinal tract. Decreased urine output (choice B) is more indicative of dehydration or renal issues. Positive Trousseau's sign (choice C) is associated with hypocalcemia, not hypercalcemia. Headache (choice D) is a nonspecific symptom and not a typical manifestation of hypercalcemia.
A nurse is assessing for allergies with a client who is scheduled to receive the influenza vaccine. Which of the following allergies should the nurse report to the provider as a possible contraindication to receiving the vaccine?
- A. Eggs
- B. Shellfish
- C. Peanuts
- D. Milk
Correct Answer: A
Rationale: The correct answer is A: Eggs. Influenza vaccines are typically produced using eggs, so individuals with egg allergies may have an allergic reaction to the vaccine. Reporting this allergy to the provider is crucial to avoid potential adverse reactions. Shellfish, peanuts, and milk allergies are not contraindications for receiving the influenza vaccine. Summary: Eggs are the correct answer due to the vaccine production method; shellfish, peanuts, and milk allergies are not relevant in this context.
A nurse is planning teaching for a client who is trying to quit smoking. Which of the following instructions about nicotine replacement options should the nurse include?
- A. Change the nicotine patch every other day.
- B. Do not drink beverages while sucking on a nicotine lozenge.
- C. Chew nicotine gum for 10 min before spitting it out.
- D. Administer 2 sprays of nicotine nasal spray in each nostril with each dose.
Correct Answer: B
Rationale: The correct answer is B: Do not drink beverages while sucking on a nicotine lozenge. This instruction is important because beverages can interfere with the absorption of nicotine from the lozenge. Nicotine replacement therapy works best when the nicotine is absorbed properly, so avoiding beverages while using the lozenge will help ensure its effectiveness. Changing the nicotine patch every other day (choice A) is incorrect as patches are typically changed daily. Chewing nicotine gum for 10 minutes before spitting it out (choice C) is incorrect as the gum should be chewed until a tingling sensation is felt, then parked between the cheek and gum. Administering 2 sprays of nicotine nasal spray in each nostril with each dose (choice D) is incorrect as the dosage is usually one spray in each nostril.
A nurse is caring for a client who is in shock and is receiving an infusion of albumin. Which of the following findings should the nurse expect?
- A. Oxygen saturation 96%
- B. PaCO2 30 mm Hg
- C. Increase in BP
- D. Decrease in protein
Correct Answer: C
Rationale: The correct answer is C: Increase in BP. Albumin is a colloid solution that helps increase blood volume and subsequently improves blood pressure in shock patients. Increasing blood volume leads to an increase in blood pressure. Option A is incorrect because oxygen saturation is not directly affected by albumin infusion. Option B is incorrect because a low PaCO2 level is not a direct effect of albumin infusion. Option D is incorrect because albumin is a protein and its infusion would not lead to a decrease in protein levels.
A nurse is providing teaching to a client who has a new prescription for theophylline, a sustained-released capsule. Which of the following statements by the client indicates an understanding of the teaching?
- A. I can take my medication in the morning with my coffee.
- B. I may sprinkle the medication in applesauce.
- C. I should limit my fluid intake while on this medication.
- D. I will need to have blood levels drawn.
Correct Answer: D
Rationale: Answer D is correct because monitoring blood levels is crucial for theophylline therapy due to its narrow therapeutic range. Regular monitoring helps ensure the drug is at a safe and effective level in the body. Taking the medication with food or fluids, as indicated in choices A and C, can affect its absorption or metabolism, leading to suboptimal effects or toxicity. Sprinkling the medication in applesauce, as in choice B, can alter the drug's sustained-release mechanism, causing rapid release and possible adverse effects. Therefore, choice D is the best option for ensuring theophylline therapy's safety and efficacy.