Nokea
The physician prescribes metoclopramide hydrochloride (Reglan) for the client with hiatal hernia. The nurse plans to instruct the client that this drug is used in hiatal hernia therapy to accomplish which of the following objectives?
- A. Increase tone of the esophageal sphincter.
- B. Neutralize gastric secretions.
- C. Ease gastric emptying.
- D. Reduce secretion of digestive juices.
Correct Answer: C
Rationale: Metoclopramide promotes gastric emptying, reducing the volume of gastric contents that can reflux in hiatal hernia.
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The nurse is caring for a client with angle-closure glaucoma. Which prescription should the nurse anticipate from the primary healthcare provider (PHCP)?
- A. timolol
- B. hydroxyzine
- C. phenylephrine
- D. imipramine
Correct Answer: A
Rationale: Timolol, a beta-blocker, reduces intraocular pressure in angle-closure glaucoma by decreasing aqueous humor production. Hydroxyzine, phenylephrine, and imipramine are not used for this condition.
The nurse is applying a prescribed 5% lidocaine patch to a client's lumbar back region. The nurse plans to remove this patch after how many hours following the application?
- A. 24 hours
- B. 72 hours
- C. 8 hours
- D. 12 hours
Correct Answer: D
Rationale: Lidocaine patches (5%) are typically applied for 12 hours and then removed for 12 hours to prevent skin irritation and systemic absorption, per standard guidelines.
Which of the following statements would indicate to the nurse that the client who has undergone repair of her nasal septum has understood the discharge instructions?
- A. I should not shower until my packing is removed.
- B. I will take stool softeners and modify my diet to prevent constipation.
- C. Coughing every 2 hours is important to prevent respiratory complications.
- D. It is important to blow my nose each day to remove the dried secretions.
Correct Answer: B
Rationale: Taking stool softeners and modifying the diet to prevent constipation avoids straining (Valsalva's maneuver), which could cause bleeding or complications post-nasal surgery.
The nurse is to administer flumazenil (Mazicon) I.V. for reversal of sedation. Which of the following interventions should be included in the care plan? Select all that apply.
- A. Administer the medication as a 2-mg bolus.
- B. Give the medication undiluted in incremental doses.
- C. Be alert for shivering and hypotension.
- D. Use only a free-flowing I.V. line in a large vein.
- E. Monitor the client's level of consciousness.
Correct Answer: B,C,D,E
Rationale: Flumazenil is given undiluted in incremental doses (B), via a free-flowing IV line (D), with monitoring for side effects like shivering and hypotension (C) and level of consciousness (E). A 2-mg bolus (A) is incorrect, as flumazenil is titrated in smaller doses.
In the early postoperative period after a bilateral adrenalectomy, the client has an increased temperature. The nurse should assess the client further for signs of:
- A. Dehydration.
- B. Poor lung expansion.
- C. Wound infection.
- D. Urinary tract infection.
Correct Answer: C
Rationale: An increased temperature post-adrenalectomy suggests wound infection, a common postoperative complication requiring prompt assessment.