Nokea
The physician has prescribed Cytoxan (cyclophosphamide) for a client with nephrotic syndrome. The nurse should:
- A. Encourage the client to drink extra fluids.
- B. Request a low-protein diet for the client.
- C. Bathe the client using only mild soap and water.
- D. Provide additional warmth for swollen and inflamed joints.
Correct Answer: A
Rationale: Cyclophosphamide is nephrotoxic; extra fluids promote excretion and reduce bladder toxicity. Low-protein diets are not indicated, mild soap is unrelated, and joints are not typically inflamed in nephrotic syndrome.
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The nurse is preparing to discharge a client who is receiving Nardil (phenelzine). The nurse should tell the client to:
- A. Wear protective clothing and sunglasses outside.
- B. Avoid medications containing pseudoephedrine.
- C. Drink six to eight glasses of water a day.
- D. Avoid foods that are high in purine.
Correct Answer: B
Rationale: Drug interactions between an MAOI and pseudoephedrine can result in hypertensive crisis. Answer A refers to the client receiving antipsychotic medications such as Thorazine, so it is incorrect. Answers C and D do not apply to MAOIs, so they are incorrect.
The nurse administers prescribed pancreatin replacement therapy to Bonnie.
To effectively evaluate the effect of this treatment, should expect that this medication will result to
- A. Bulky, foul, smelly stools.
- B. Close to normal stools.
- C. Loose, frequent stools.
- D. Constipation.
Correct Answer: B
Rationale: Pancreatin aids fat digestion, resulting in near-normal stools in pancreatic insufficiency.
As a client progresses through pregnancy, she develops constipation. What is the primary cause of this problem during pregnancy?
- A. Decreased appetite
- B. Inadequate fluid intake
- C. Prolonged gastric emptying
- D. Reduced intestinal motility
Correct Answer: D
Rationale: During pregnancy, hormonal changes and mechanical pressure reduce motility in the small intestine, enhancing water absorption and promoting constipation. Although decreased appetite, inadequate fluid intake, and prolonged gastric emptying may contribute to constipation, they aren't the primary cause.
A client has been admitted in septic shock. Her nursing care plan includes the diagnosis High Risk for Injury (related to clotting disorder). Based on this diagnosis, all the following are appropriate entries in the nursing care plan except:
- A. obtain an order for a stool softener.
- B. administer packed RBCs, if ordered.
- C. encourage the client to rinse her mouth with mouthwash and scrub her teeth with an oral sponge.
- D. dress venipuncture sites immediately to prevent infection.
Correct Answer: D
Rationale: Firm, direct pressure should be applied to venipuncture sites for 3-7 minutes before final dressing because of the clotting abnormality.
Mr. Smith is 67-year-old black male brought to the hospital by his wife, who stated that he fell down 20 minutes ago and has been unable to speak or move his right side since then, Mr. Smith has no significant past medical history. On exam, Mr. Smith is conscious, very anxious, his speech is garbed and unintelligible, he has a left facial droop, and he is completely right hemiphlegic.
The most likely etiology for his symptoms is:
- A. CVA
- B. Traumatic brain injury
- C. Brain tumor
- D. Alzheimer's disease
Correct Answer: A
Rationale: Symptoms of sudden speech loss, facial droop, and hemiplegia strongly suggest a cerebrovascular accident (stroke).