Nokea
The physician orders Zestril (lisinopril) and Lasix (furosemide) to be administered at the same time to a client with hypertension. The nurse should:
- A. Question the order
- B. Administer the medications as ordered
- C. Administer the medications separately
- D. Contact the pharmacy
Correct Answer: B
Rationale: Lisinopril (an ACE inhibitor) and furosemide (a diuretic) are commonly prescribed together for hypertension to reduce blood pressure synergistically. Administering them as ordered is appropriate as there is no contraindication to concurrent use.
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The nurse is caring for a client in labor. The fetal heart rate is 80 bpm with moderate variability. The most appropriate initial action by the nurse is to:
- A. Notify the physician
- B. Administer oxygen at 8-10 liters per minute
- C. Reposition the client to her left side
- D. Increase the IV fluid rate
Correct Answer: C
Rationale: A fetal heart rate of 80 bpm indicates bradycardia possibly due to cord compression or uteroplacental insufficiency. Repositioning the client to her left side improves placental perfusion and is the first action. Oxygen notifying the physician or increasing fluids are secondary.
The nurse is assessing the client’s bowel sounds. Which finding indicates normal bowel sounds?
- A. Stronger than normal
- B. Hypoactive
- C. Normal
- D. Hyperactive
Correct Answer: C
Rationale: Normal bowel sounds are described as 'normal,' occurring every 5–20 seconds with a gurgling quality. Stronger than normal or hyperactive sounds suggest increased motility (e.g., diarrhea), while hypoactive sounds indicate reduced motility (e.g., ileus).
A chronic alcoholic client's condition deteriorates, and he begins to exhibit signs of hepatic coma. Which of the following is an early sign of impending hepatic coma?
- A. Hiccups
- B. Anorexia
- C. Mental confusion
- D. Fetor hepaticus
Correct Answer: C
Rationale: One of the earliest symptoms of hepatic coma is mental confusion. Asterixis, a flapping tremor of the hand, may also be seen.
A client with a history of Crohn's disease is admitted with a small bowel obstruction. The nurse should give priority to:
- A. Monitoring for dehydration
- B. Administering pain medication
- C. Preparing for surgery
- D. Providing nutritional supplements
Correct Answer: A
Rationale: Small bowel obstruction in Crohn's disease can cause fluid loss through vomiting or sequestration, making monitoring for dehydration the priority to prevent hypovolemia.
A client with pregnancy-induced hypertension is scheduled for a C-section. Before surgery, the nurse should keep the client:
- A. On her right side
- B. Supine with a small pillow
- C. On her left side
- D. In knee chest position
Correct Answer: C
Rationale: The left lateral position improves uteroplacental blood flow in pregnancy-induced hypertension, reducing fetal distress risk. Right-sided, supine, or knee-chest positions are less optimal.