Nokea
When an elderly client is receiving cimetidine [Tagamet], it is important that the nurse monitor for which side effect?
- A. Chest pain
- B. Confusion
- C. Dyspnea
- D. Urinary retention
Correct Answer: B
Rationale: Confusion is a potential side effect of cimetidine in elderly clients due to its central nervous system effects.
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The client receiving antibiotic therapy complains of white, cheesy plaques in the mouth. Which intervention should the nurse implement?
- A. Notify the health-care provider to obtain an antifungal medication.
- B. Explain the patches will go away naturally in about two (2) weeks.
- C. Instruct to rinse the mouth with diluted hydrogen peroxide and water daily.
- D. Allow the client to verbalize feelings about having the plaques.
Correct Answer: A
Rationale: White, cheesy plaques suggest oral candidiasis, a common side effect of antibiotics. Notifying the HCP for an antifungal medication is the most appropriate intervention. The patches won’t resolve naturally, hydrogen peroxide is not standard, and verbalizing feelings is secondary.
A client had a barium enema. Following the barium enema, the nurse should anticipate an order for which of the following?
- A. An antacid
- B. A laxative
- C. A muscle relaxant
- D. A sedative
Correct Answer: B
Rationale: Barium is constipating, and a laxative is typically ordered to prevent bowel obstruction post-barium enema.
The RN overhears the LPN talking with the client who is being prepared for a total colectomy with the creation of an ileoanal reservoir for ulcerative colitis. Which statement made by the LPN should the RN clarify to decrease the client’s anxiety?
- A. “This surgery will prevent you from developing colon cancer.”
- B. “After this surgery you will no longer have ulcerative colitis.”
- C. “After surgery you may not have solid food for several days.”
- D. “You’ll have a permanent ileostomy after having this surgery.”
Correct Answer: D
Rationale: A. The client will not be at risk for colon cancer because with a total colectomy the entire colon is removed. B. Since this surgery removes the total colon, the ulcerative colitis will be cured. C. The client will be unable to eat until peristalsis returns, and then it may take several days before solid foods are tolerated. D. The client will initially have an ileostomy; after the reservoir has healed, the ileostomy will be closed. Knowing that the ileostomy will be temporary is important information for the client to decrease anxiety.
Which outcome should the nurse identify for the client diagnosed with aphthous stomatitis?
- A. The client will be able to cope with perceived stress.
- B. The client will consume a balanced diet.
- C. The client will deny any difficulty swallowing.
- D. The client will take antacids as prescribed.
Correct Answer: C
Rationale: Aphthous stomatitis (canker sores) can cause painful swallowing, so denying difficulty swallowing is a key outcome. Stress coping and diet are secondary, and antacids are irrelevant.
The client is one (1) day postoperative major abdominal surgery. Which client problem is priority?
- A. Impaired skin integrity.
- B. Fluid and electrolyte imbalance.
- C. Altered bowel elimination.
- D. Altered body image.
Correct Answer: B
Rationale: Fluid and electrolyte imbalance is the priority due to risks of dehydration or imbalances from surgery, impacting hemodynamic stability. Skin integrity, bowel elimination, and body image are secondary in the immediate postoperative period.