Nokea
The physician prescribes captopril (Capoten) 25 mg po tid for the client with hypertension. Which of the following adverse reactions can occur with administration of Capoten?
- A. Tinnitus
- B. Persistent cough
- C. Muscle weakness
- D. Diarrhea
Correct Answer: B
Rationale: Captopril, an ACE inhibitor, commonly causes a persistent dry cough.
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The nurse is caring for a laboring client who is on an oxytocin infusion. The client experiences seven contractions in a 10-minute time period. The fetal heart rate tracing is a category III. Which action should the nurse take?
- A. discontinue the oxytocin infusion
- B. increase the oxytocin infusion rate
- C. decrease the oxytocin infusion rate by half
- D. reposition the client into a high-Fowler's position
Correct Answer: A
Rationale: A category III fetal heart rate tracing indicates fetal distress, and seven contractions in 10 minutes suggest uterine hyperstimulation. Discontinuing oxytocin is the priority to reduce fetal stress.
A client with AIDS tells the nurse that he regularly takes echinacea to boost his immune system. The nurse should tell the client that:
- A. Herbals can interfere with the action of antiviral medication
- B. Supplements have proven effective in prolonging life
- C. Herbals have been shown to decrease the viral load
- D. Supplements appear to prevent replication of the virus
Correct Answer: A
Rationale: Echinacea may interact with antiretroviral medications, potentially reducing their effectiveness.
A client who is Muslim is refusing to eat food served to him by a nursing assistant. The nurse should do which of the following? Select all that apply.
- A. arrange a mealtime that will avoid prayer times
- B. remove farm-raised catfish from the food tray
- C. arrange with the family for halal food to be brought from home
- D. deliver food by a nursing assistant of the same sex
Correct Answer: A, C
Rationale: Arranging mealtimes to avoid prayer times and providing halal food respects the client's religious dietary practices. The gender of the assistant and specific foods like catfish are less relevant unless explicitly non-halal.
The physician has made a diagnosis of 'shaken child' syndrome for a 13-month-old who was brought to the emergency room after a reported fall from his highchair. Which finding supports the diagnosis of 'shaken child' syndrome?
- A. Fracture of the clavicle
- B. Periorbital bruising
- C. Retinal hemorrhages
- D. Fracture of the humerus
Correct Answer: C
Rationale: Retinal hemorrhages are a hallmark of shaken baby syndrome due to the shearing forces from violent shaking causing bleeding in the retina.
The nurse is evaluating the intake and output of a client for the first 12 hours following an abdominal cholecystectomy. Which finding should be reported to the physician?
- A. Output of 10 mL from the Jackson-Pratt drain
- B. Foley catheter output of 285 mL
- C. Nasogastric tube output of 150 mL
- D. Absence of stool
Correct Answer: D
Rationale: Absence of stool post-cholecystectomy may indicate a complication like ileus or obstruction, requiring physician evaluation.