Nokea
The physician has prescribed Chloromycetin (chloramphenicol) for a client with bacterial meningitis. Which lab report should the nurse monitor most carefully?
- A. Serum creatinine
- B. Urine specific gravity
- C. Complete blood count
- D. Serum sodium
Correct Answer: C
Rationale: Chloramphenicol can cause bone marrow suppression, so monitoring the complete blood count is critical.
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A client with clotting disorder has an order to continue Lovenox (enoxaparin) injections after discharge. The nurse should teach the client that Lovenox injections should:
- A. Be injected into the deltoid muscle
- B. Be injected into the abdomen
- C. Aspirate after the injection
- D. Clear the air from the syringe before injections
Correct Answer: B
Rationale: Lovenox is injected into the abdomen to ensure proper subcutaneous absorption and minimize bruising.
The client with dementia is experiencing confusion late in the afternoon and before bedtime. The nurse is aware that the client is experiencing what is known as:
- A. Chronic fatigue syndrome
- B. Normal aging
- C. Sundowning
- D. Delusions
Correct Answer: C
Rationale: Sundowning is a common phenomenon in dementia where confusion worsens in the late afternoon and evening.
A client with primary sclerosing cholangitis has received a liver transplant. The nurse should give priority to assessing the client for complications. Which findings are associated with an acute rejection of the new liver?
- A. Increased jaundice and prolonged prothrombin time
- B. Fever and foul-smelling bile drainage
- C. Abdominal distention and clay-colored stools
- D. Increased uric acid and increased creatinine
Correct Answer: A
Rationale: Increased jaundice and prolonged prothrombin time indicate liver dysfunction, consistent with acute liver transplant rejection.
A student nurse is developing a care plan for a 23-year-old woman with Meniere's disease. Which of the following would NOT be an expected intervention?
- A. administer narcotic pain medication PRN as ordered
- B. refer client to dietician to plan meals with reduced sodium levels
- C. assist client out of bed to shower and to toilet
- D. encourage client to eat several, similarly sized meals throughout the day
Correct Answer: A
Rationale: Meniere’s disease causes vertigo and hearing loss, not typically requiring narcotic pain medication. Low-sodium diets, assistance with mobility, and balanced meals help manage symptoms.
The nurse is caring for a client with uremic frost. The nurse is aware that uremic frost is often seen in clients with:
- A. Severe anemia
- B. Arteriosclerosis
- C. Liver failure
- D. Parathyroid disorder
Correct Answer: C
Rationale: Uremic frost, a powdery deposit on the skin, is associated with end-stage renal failure, not liver failure, but the options suggest a contextual error; renal failure is the intended association.