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To protect a client who has received tissue plasminogen activator (t-PA, or Activase) therapy, the nurse should:
- A. Use the radial artery to obtain blood gas samples.
- B. Maintain arterial pressure for 10 seconds.
- C. Administer I.M. injections.
- D. Encourage physical activity.
Correct Answer: B
Rationale: Maintaining pressure on arterial puncture sites for 10 seconds minimizes bleeding risk, critical after t-PA due to its thrombolytic effects.
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A client with a history of hypothyroidism is prescribed levothyroxine (Synthroid). The nurse should instruct the client to:
- A. Take the medication at bedtime.
- B. Avoid taking the medication with grapefruit juice.
- C. Take the medication with a high-fiber meal.
- D. Stop the medication if palpitations occur.
Correct Answer: B
Rationale: Grapefruit juice can interfere with levothyroxine absorption, so it should be avoided.
Identify this cardiac rhythm strip. Fill in the blank. A. Idioventricular Rhythm B. Bundle Branch Block C. Sinus bradycardia D. Atrial Flutter
- B. Idioventricular Rhythm
- C. Bundle Branch Block
- D. Sinus bradycardia
- E. Atrial Flutter
Correct Answer: C
Rationale: Sinus bradycardia is characterized by a regular rhythm with a rate below 60 beats per minute, assuming the strip shows this pattern.
The nurse is caring for a client with a history of atrial fibrillation who is prescribed dronedarone (Multaq). The nurse should monitor the client for which of the following side effects?
- A. Hypertension.
- B. Bradycardia.
- C. Liver toxicity.
- D. Weight gain.
Correct Answer: C
Rationale: Dronedarone can cause liver toxicity, requiring regular monitoring of liver function tests.
A client with a history of chronic obstructive pulmonary disease (COPD) is prescribed fluticasone (Flovent). The nurse should instruct the client to:
- A. Rinse the mouth after inhalation.
- B. Use the inhaler as needed for shortness of breath.
- C. Take the inhaler with meals.
- D. Stop the inhaler if dizziness occurs.
Correct Answer: A
Rationale: Rinsing the mouth after fluticasone inhalation prevents oral thrush.
Following cardiac bypass surgery, the client has been referred to a cardiac rehabilitation exercise program. The client is a diabetic and has bilateral leg discomfort with walking. The nurse should advise the client to exercise using a stationary bicycle and intermittent training because of the client's:
- A. Diabetic neuropathy
- B. Muscle atrophy
- C. Raynaud's disease
- D. Transient ischemic attacks
Correct Answer: A
Rationale: Diabetic neuropathy likely causes the client's leg discomfort, making low-impact, intermittent stationary cycling suitable to avoid exacerbating symptoms. Other conditions are less likely causes.