Nokea
The physician has ordered mannitol IV for a client with a head injury. What should the nurse closely monitor because the client is receiving mannitol?
- A. Deep tendon reflexes
- B. Urine output
- C. Level of orientation
- D. Pulse rate
Correct Answer: B
Rationale: Mannitol is a diuretic, so monitoring urine output is critical to assess its effectiveness and prevent dehydration.
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Which referral is most important for the nurse to implement for the client with permanent hearing loss?
- A. Aural rehabilitation.
- B. Speech therapist.
- C. Social worker.
- D. Vocational rehabilitation.
Correct Answer: A
Rationale: Aural rehabilitation addresses communication strategies and hearing aids, critical for permanent hearing loss. Speech therapy, social work, and vocational rehab are secondary.
The nurse is caring for a client who is very hard of hearing. How should the nurse communicate with this person?
- A. Speak loudly and talk in his better ear
- B. Stand in front of him and speak clearly and distinctly
- C. Yell at him using a high-pitched voice
- D. Write all communication on a note pad or magic slate
Correct Answer: B
Rationale: Standing in front and speaking clearly aids lip-reading and communication for a hard-of-hearing client.
The client with severe otitis media and mastoiditis is prescribed levofloxacin IV, 250 mg every 12 hours. The medication is diluted in 100 mL of NS. To deliver the antibiotic in 30 minutes, the nurse must infuse the solution at a rate of how many mL per hour?
- A. 200
Correct Answer: A
Rationale: The rate of IV infusion is calculated as follows: 100 mL over 30 minutes equals X mL over 60 minutes. Thus, 100/30 = X/60, so X = (100 × 60) / 30 = 200 mL/hr.
The nurse is planning the care of the client with Meniere's disease. With which member of the interdisciplinary team should the nurse expect a consultation?
- A. Rheumatologist
- B. Otolaryngologist
- C. Physical therapist
- D. Oncologist
Correct Answer: B
Rationale: Since Meniere's disease is a condition of the ear, the nurse would plan to include the otolaryngologist. Rheumatologists, physical therapists, and oncologists treat unrelated conditions.
Which behavior by the male client should make the nurse suspect the client has a hearing loss? Select all that apply.
- A. The client reports hearing voices in his head.
- B. The client becomes irritable very easily.
- C. The client has difficulty making decisions.
- D. The client’s wife reports he ignores her.
- E. The client does not dominate a conversation.
Correct Answer: B,D,E
Rationale: Irritability, ignoring others, and not dominating conversations suggest hearing loss due to social withdrawal or misunderstanding. Hearing voices is psychiatric, and decision-making is unrelated.