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Which is the most important safety measure when administering a medication through a patient's central venous catheter (CVC)?
- A. Using a sterile technique
- B. Ensuring correct placement of the CVC
- C. Flushing the CVC with saline after administration
- D. Monitoring for signs of infection
Correct Answer: B
Rationale: The most important safety measure when administering a medication through a patient's central venous catheter (CVC) is ensuring the correct placement of the CVC. This is crucial to prevent complications such as extravasation, infection, or improper drug delivery. While using a sterile technique, flushing the CVC with saline after administration, and monitoring for signs of infection are all important aspects of CVC care, ensuring the correct placement of the catheter takes precedence as it directly impacts patient safety during medication administration.
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In which condition is the 'butterfly rash' most commonly seen?
- A. Systemic lupus erythematosus
- B. Rheumatoid arthritis
- C. Psoriasis
- D. Dermatomyositis
Correct Answer: A
Rationale: The correct answer is A: Systemic lupus erythematosus (SLE). The 'butterfly rash' across the cheeks and nose is a classic sign of SLE, an autoimmune disease. This rash is a key dermatological manifestation of SLE, often triggered or worsened by exposure to sunlight. Choices B, C, and D are incorrect because the 'butterfly rash' is not commonly associated with rheumatoid arthritis, psoriasis, or dermatomyositis.
The PN notes that a UAP is ambulating a male client who had a stroke and has right-sided weakness. The UAP is walking on the client's left side. Which action should the PN take?
- A. Instruct the UAP to walk on the client's affected side
- B. Take over the ambulation and provide guidance to the UAP immediately
- C. Provide the client with an assistive device, such as a cane or walker
- D. Tell the UAP to take the client back to his room
Correct Answer: A
Rationale: The correct action for the PN to take is to instruct the UAP to walk on the client's affected side. This is essential to provide the necessary support and prevent falls, especially when the client has weakness on one side due to a stroke. Walking on the affected side helps provide stability and assistance to the weaker side. Choice B is incorrect because it would be more appropriate for the PN to provide immediate guidance and correct the UAP's positioning rather than taking over the task completely. Choice C is incorrect because while assistive devices may be beneficial, the immediate concern is the UAP's positioning during ambulation, not providing the client with an assistive device. Choice D is incorrect as there is no indication to return the client to his room unless it is necessary for his safety or well-being.
A male client with TB returns to the clinic for daily antibiotic injections for a urinary infection. The client has been taking anti-tubercular medications for 10 weeks and states he has ringing in his ears. Which prescribed medication should the PN report to the HCP?
- A. Pyridoxine with a B complex multivitamin
- B. Gentamicin 160 mg IM daily
- C. Rifampin 600 mg PO daily
- D. Isoniazid 300 mg PO daily
Correct Answer: B
Rationale: The correct answer is B: Gentamicin 160 mg IM daily. Gentamicin is an aminoglycoside antibiotic that can cause ototoxicity, leading to ringing in the ears (tinnitus). This symptom should be reported to the HCP immediately, as it may indicate a need to adjust or discontinue the medication. Choice A, Pyridoxine with a B complex multivitamin, is not the cause of ototoxicity. Choices C and D, Rifampin and Isoniazid, are anti-tubercular medications but are not associated with causing ringing in the ears.
The practical nurse is caring for a client whose urine drug screen is positive for cocaine. Which behavior is this client likely to exhibit during cocaine withdrawal?
- A. Elevated energy level
- B. Euphoria
- C. High self-esteem
- D. Powerful craving for more
Correct Answer: D
Rationale: The correct answer is D: Powerful craving for more. During cocaine withdrawal, individuals often experience intense cravings for the drug, along with symptoms such as fatigue, depression, and anxiety. These cravings can be overpowering and lead to a strong desire to seek out more cocaine to alleviate the withdrawal symptoms. Choices A, B, and C are incorrect as elevated energy level, euphoria, and high self-esteem are more associated with the effects of cocaine rather than withdrawal symptoms. Withdrawal from cocaine is characterized by the opposite, such as fatigue, low mood, and intense cravings.
Which of the following is an appropriate intervention for a patient experiencing a hypertensive crisis?
- A. Placing the patient in a supine position
- B. Administering a beta-blocker intravenously
- C. Encouraging the patient to drink fluids
- D. Applying a cold compress to the forehead
Correct Answer: B
Rationale: Administering a beta-blocker intravenously is the correct intervention for a patient experiencing a hypertensive crisis. Beta-blockers help quickly reduce blood pressure and prevent complications such as stroke or heart attack. Placing the patient in a supine position can worsen the condition by reducing venous return and increasing the workload of the heart. Encouraging the patient to drink fluids is not recommended as it can exacerbate hypertension by increasing fluid volume. Applying a cold compress to the forehead does not address the underlying cause of the hypertensive crisis and is unlikely to provide significant benefit.