Nokea
The physician has ordered an infusion of Osmitrol (mannitol) for a client with increased intracranial pressure. Which finding indicates the direct effectiveness of the drug?
- A. Increased pulse rate
- B. Increased urinary output
- C. Decreased diastolic blood pressure
- D. Increased pupil size
Correct Answer: B
Rationale: Mannitol is an osmotic diuretic that reduces intracranial pressure by increasing urinary output, drawing fluid out of the brain tissue.
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A 23-year-old woman who is 16 weeks pregnant is seen by the nurse for a routine maternal-child clinic appointment. The client has had erratically controlled type 1 diabetes since 12 years old. The client asks the nurse if she is at risk during her pregnancy. The nurse instructs the client she should do which of the following actions to limit complications for both her and her baby? Select all that apply.
- A. eat healthy foods
- B. refrain from exercise
- C. take medications as directed
- D. monitor her blood sugar before every meal
Correct Answer: A, C, D
Rationale: Healthy eating, taking insulin as directed, and monitoring blood sugar before meals help control diabetes and reduce pregnancy complications. Exercise is generally encouraged, not avoided.
A client's serum sodium level is 113 mEq/L. The nurse would expect which findings upon assessment?
- A. headache, confusion, muscle weakness, fatigue
- B. hypertension, muscle cramps, respiratory depression
- C. cardiac arrhythmia, tetany, tachycardia
- D. confusion, nystagmus, tetany, hallucinations
Correct Answer: A
Rationale: Severe hyponatremia (113 mEq/L) causes neurological symptoms like headache, confusion, muscle weakness, and fatigue due to cerebral edema.
The physician has prescribed tranylcypromine sulfate (Parnate) 10 mg bid. The nurse should teach the client to refrain from eating foods containing tyramine because it may cause:
- A. Hypertension
- B. Hyperthermia
- C. Hypotension
- D. Urinary retention
Correct Answer: A
Rationale: Tyramine with MAOIs like tranylcypromine can cause a hypertensive crisis.
A client is to be discharged 48 hours after a normal vaginal delivery of an infant with no laceration or episiotomy. Which of the following danger signs should the client be advised to report to her physician? Select all that apply.
- A. Temperature higher than 38°C/100.4°F
- B. Difficulty urinating
- C. Swelling, redness, or pain in one or both legs
- D. Fatigue
- E. Foul-smelling vaginal discharge
Correct Answer: A,B,C,E
Rationale: Postpartum danger signs include fever >38°C (A), difficulty urinating (B), leg swelling/redness/pain (C, indicating possible DVT), and foul-smelling discharge (E, suggesting infection). Fatigue (D) is common and not necessarily a danger sign.
Which client is at risk for opportunistic diseases such as pneumocystis pneumonia?
- A. The client with cancer who is being treated with chemotherapy
- B. The client with Type I diabetes
- C. The client with thyroid disease
- D. The client with Addison's disease
Correct Answer: A
Rationale: Chemotherapy suppresses the immune system, increasing the risk of opportunistic infections like pneumocystis pneumonia.