Nokea
Which aminophylline level is associated with signs of toxicity?
- A. 5 micrograms/mL
- B. 10 micrograms/mL
- C. 20 micrograms/mL
- D. 25 micrograms/mL
Correct Answer: D
Rationale: Aminophylline levels above 20 micrograms/mL are toxic, causing symptoms like nausea, tachycardia, or seizures. 25 micrograms/mL is well above the therapeutic range (10-20).
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A 55-year-old client is unconscious, and his physician has decided to begin tube feeding him using a small-bore silicone feeding tube (Keofeed, Duo-Tube). After the tube is inserted, the nurse identifies the most reliable way to confirm appropriate placement is to:
- A. Aspirate gastric contents
- B. Auscultate air insufflated through the tube
- C. Obtain a chest x-ray
- D. Place the tip of the tube under water and observe for air bubbles
Correct Answer: C
Rationale: A chest x-ray is the most reliable method to confirm small-bore feeding tube placement, as other methods may be inconclusive or unreliable.
The nurse is caring for a client with a diagnosis of placenta accreta. Which intervention is most appropriate?
- A. Prepare for possible hysterectomy
- B. Administer tocolytics
- C. Monitor fetal heart tones
- D. Administer antibiotics
Correct Answer: A
Rationale: Placenta accreta often prevents placental separation leading to severe hemorrhage during delivery which may necessitate hysterectomy. Tocolytics fetal monitoring and antibiotics are not primary interventions for this condition.
The obstetric client's fetal heart rate is 80-90 during the contractions. The first action the nurse should take is:
- A. Reposition the monitor
- B. Turn the client to her left side
- C. Ask the client to ambulate
- D. Prepare the client for delivery
Correct Answer: B
Rationale: A fetal heart rate of 80-90 during contractions indicates bradycardia possibly from cord compression or uteroplacental insufficiency. Turning the client to her left side improves placental perfusion and is the first action.
A client with a history of hypertension is receiving Aldactone (spironolactone). The nurse should teach the client to avoid:
- A. Potassium-rich foods
- B. Calcium supplements
- C. High-fiber foods
- D. Iron supplements
Correct Answer: A
Rationale: Spironolactone is a potassium-sparing diuretic, and consuming potassium-rich foods can lead to hyperkalemia. Calcium, fiber, and iron supplements are not contraindicated.
The nurse is caring for a client with a diagnosis of gestational hypertension. Which intervention is most appropriate?
- A. Monitor blood pressure
- B. Administer antihypertensives
- C. Monitor fetal heart tones
- D. All of the above
Correct Answer: D
Rationale: Gestational hypertension requires blood pressure monitoring to assess severity antihypertensives for severe hypertension and fetal heart tone monitoring to ensure fetal well-being. All interventions are appropriate.