Nokea
When developing a teaching plan for a client who is prescribed acetaminophen (Tylenol) for muscle pain, which information should the nurse expect to include? Select all that apply.
- A. The drug can be used if the person is allergic to aspirin.
- B. Acetaminophen does not affect platelet aggregation.
- C. This drug causes little or no gastric distress.
- D. Acetaminophen exerts a strong antiinflammatory effect.
- E. The client should have the International Normalized Ratio (INR) checked regularly.
Correct Answer: A,B,C
Rationale: Acetaminophen is safe for aspirin allergies, does not affect platelets, and causes minimal gastric distress. It has weak anti-inflammatory effects and does not require INR monitoring.
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Three weeks after the client has had an ileostomy, the nurse is following up with instruction about using a skin barrier around the stoma at all times. The client has been applying the skin barrier correctly when:
- A. There is no odor from the stoma.
- B. The client is adequately hydrated.
- C. There is no skin irritation around the stoma.
- D. The client only changes the ostomy pouch once a day.
Correct Answer: C
Rationale: Correct application of a skin barrier is indicated by no skin irritation around the stoma, as the barrier protects the peristomal skin. Odor, hydration, and pouch change frequency are not direct indicators of proper barrier use. CN: Physiological adaptation; CL: Evaluate
Which of the following should lead the nurse to suspect that a client with a fracture of the right femur may be developing a fat embolus?
- A. Acute respiratory distress syndrome.
- B. Migraine-like headaches.
- C. Numbness in the right leg.
- D. Muscle spasms in the right thigh.
Correct Answer: A
Rationale: Fat embolism commonly presents with acute respiratory distress, a life-threatening complication of femoral fractures.
A client with microcytic anemia is having trouble selecting food from the hospital menu. Which food is best for the nurse to suggest for satisfying the client's nutritional needs?
- A. Egg yolks.
- B. Brown rice.
- C. Vegetables.
- D. Tea.
Correct Answer: A
Rationale: Microcytic anemia is often due to iron deficiency. Egg yolks are a good source of iron, particularly heme iron, which is highly bioavailable. Brown rice and vegetables contain non-heme iron but in lower amounts, and tea inhibits iron absorption due to tannins. Egg yolks are the best choice.
Which of the following symptoms should the nurse teach the client with unstable angina to report immediately to her physician?
- A. A change in the pattern of her pain.
- B. Pain during sexual activity.
- C. Pain during an argument with her husband.
- D. Pain during or after an activity such as lawn-mowing.
Correct Answer: A
Rationale: A change in the pattern of angina pain may indicate worsening ischemia or progression to unstable angina or MI, requiring immediate medical attention.
A client with acute respiratory distress syndrome (ARDS) is on a ventilator. The client's peak inspiratory pressures and spontaneous respiratory rate are increasing, and the PO2 is not improving. Using the SBAR (Situation-Background-Assessment-Recommendation) technique for communication, the nurse calls the physician with the recommendation for:
- A. Initiating I.V. sedation.
- B. Starting a high-protein diet.
- C. Providing pain medication.
- D. Increasing the ventilator rate.
Correct Answer: A
Rationale: Increasing peak pressures, respiratory rate, and poor PO2 suggest agitation or asynchrony; I.V. sedation improves ventilator synchrony. Diet and pain medication are irrelevant. Increasing ventilator rate may worsen lung injury.