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Which statement by the client prescribed calcitonin, a thyroid hormone, indicates to the nurse the teaching has been effective?
- A. I should administer the mediation in a different nostril each day.'
- B. I need to drink a lot of water when I take my medicine.'
- C. I have to dilute the medication with vitamin D before I take it.'
- D. This medication will help the calcium leave my bones.'
Correct Answer: A
Rationale: Alternating nostrils for nasal calcitonin prevents irritation, indicating effective teaching. Water intake, vitamin D dilution, and calcium loss are incorrect.
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The client with Alzheimer's dementia is being admitted to the nursing unit following a hip hemiarthroplasty to treat a hip fracture. Which initial intervention should the nurse plan for the client's pain control?
- A. Apply a fentanyl transdermal patch and replace after 24 hours.
- B. Start morphine sulfate per patient-controlled analgesia (PCA) with a basal rate.
- C. Administer intravenous morphine sulfate based on the client's report of pain.
- D. Administer scheduled doses of morphine sulfate intravenously around the clock.
Correct Answer: D
Rationale: D. In addition to scheduling pain medication around the clock, supplemental NSAIDs can be given to reduce inflammation and enhance the effects of the analgesic.
The nurse is assessing the leg of a client in Russell's traction. Which area is it essential to assess?
- A. Pedal area
- B. Femoral area
- C. Popliteal area
- D. Inner aspect of the thigh
Correct Answer: A
Rationale: Assessing the pedal area checks for circulation, sensation, and movement, critical in traction to detect neurovascular compromise.
The nurse is administering 0730 medications to clients on a medical orthopedic unit. Which medication should be administered first?
- A. The daily cardiac glycoside to a client diagnosed with back pain and heart failure.
- B. The routine insulin to a client diagnosed with neck strain and type 1 diabetes.
- C. The oral proton pump inhibitor to a client scheduled for a laminectomy this a.m.
- D. The fourth dose of IV antibiotic for a client diagnosed with a surgical infection.
Correct Answer: B
Rationale: Insulin for type 1 diabetes prevents hyperglycemia, a life-threatening risk, and takes priority. Cardiac glycoside, PPI, and antibiotics are important but less urgent.
What should the nurse do after noting serosanguineous drainage on the cast of a child with myelodysplasia post-TEV repair?
- A. Cut a window where the drainage is seeping through the cast.
- B. Petal the cast to minimize skin irritation and decrease leakage.
- C. Measure the area of drainage on the cast and document this.
- D. Telephone the surgeon to report the serosanguineous drainage.
Correct Answer: C
Rationale: Measuring and documenting the drainage allows monitoring without compromising the cast's integrity.
The client has been in a body cast for the past 2 days to treat numerous broken vertebrae from a fall. The client is reporting dyspnea, vomiting, epigastric pain, and abdominal distention. Which action demonstrates the nurse's best clinical judgment?
- A. Immediately notify the health care provider.
- B. Initiate oxygen at 2 liters per nasal cannula.
- C. Place ice packs around the outside of the cast.
- D. Administer ondansetron prescribed q6h prn.
Correct Answer: A
Rationale: A. The nurse should immediately notify the HCP. A window in the abdominal portion of the cast or bivalving is needed to relieve the pressure.