Nokea
Which medication prescriptions should the nurse question? Select all that apply.
- A. Cephalexin for a client with severe allergy to penicillin
- B. Fexofenadine for a client with hives
- C. Ibuprofen for a client with asthma and nasal polyps
- D. Lisinopril for a client with diabetes mellitus
- E. Propranolol for a client with asthma
Correct Answer: A,C,E
Rationale: Cephalexin (A) is contraindicated in penicillin allergy due to cross-reactivity risk. Ibuprofen (C) can trigger bronchospasm in aspirin-exacerbated respiratory disease, common in asthma with nasal polyps. Propranolol (E) is contraindicated in asthma due to beta-blockade causing bronchoconstriction. Fexofenadine (B) is safe for hives, and lisinopril (D) is appropriate for diabetes to protect kidneys.
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The male client had a hemicolectomy. The client is refusing to wear the prescribed sequential compression devices (SCDs). What is most important for the nurse to communicate to the client?
- A. An appropriate form must be signed, verifying refusal
- B. Complications, including death, could result
- C. The client will be billed for the equipment regardless
- D. The surgeon will be informed of the refusal
Correct Answer: B
Rationale: SCDs prevent deep vein thrombosis (DVT) post-surgery, a potentially fatal complication. Communicating the risk of complications, including death (B), is critical to emphasize the importance of compliance. Signing a refusal form (A), billing (C), or informing the surgeon (D) are secondary to ensuring the client understands the serious risks.
Which statements involve acceptable use of an abbreviation, symbol, or dose designation in documentation? Select all that apply.
- A. 7 cm x 3 cm x 1 cm stage II decubitus noted on left shin.
- B. 40 u SSRI administered to cover capillary glucose of 160 mg/dL.
- C. Dose of 0.5 mg hydromorphone administered and the client feels better.
- D. 4 Maalox 5 mL PO administered pc as requested for c/o heartburn.
- E. Spouse voiced understanding of home urinary catheterization QID.
Correct Answer: A
Rationale: Metric units (A), decimal doses (C), and QID (E) are clear and acceptable. 'u' (B) risks confusion with '0,' and 'pc' with 'c/o' (D) are ambiguous, per safety standards.
The nurse is caring for a 9-year-old client with cystic fibrosis who is scheduled to receive pancrelipase at 1200. The client states, 'I am not hungry now. I want to eat lunch in a few hours.' Which of the following actions should the nurse take?
- A. Omit the dose of medication.
- B. Administer half the dose of medication.
- C. Administer the dose of medication with a small snack
- D. Hold the dose of medication until the client is ready to eat.
Correct Answer: C
Rationale: Pancrelipase aids digestion in cystic fibrosis and should be taken with food. A small snack (C) ensures enzyme effectiveness while respecting the child’s appetite. Omitting (A) or halving (B) the dose risks malabsorption, and holding (D) delays nutrition.
The nurse assists with a community teaching program for parents and caregivers of infants. Which statement by a participant indicates that teaching has been successful?
- A. After age 6 months, it's safe to use honey to sweeten my infant's formula
- B. I should wait until my infant is 1 year old to introduce egg products
- C. I switch my 1-year-old to low-fat milk instead of commercial formula
- D. My infant should be able to pick up small finger foods by age 12 months
Correct Answer: B,D
Rationale: Honey (A) is unsafe for infants under 1 year due to the risk of botulism. Waiting until 1 year to introduce egg products (B) is correct to reduce allergy risks. Switching to low-fat milk (C) is incorrect, as infants need whole milk or formula for adequate fat and nutrients. The ability to pick up finger foods by 12 months (D) is a correct developmental milestone, indicating successful teaching.
While teaching the family of a child who will take phenytoin (Dilantin) regularly for seizure control, it is most important for the nurse to teach them about which of the following actions?
- A. Maintain good oral hygiene and dental care
- B. Omit medication if the child is seizure free
- C. Administer acetaminophen to promote sleep
- D. Serve a diet that is high in iron
Correct Answer: A
Rationale: Swollen and tender gums occur often with use of phenytoin. Good oral hygiene and regular visits to the dentist should be emphasized.