Nokea
Which type of hepatitis is transmitted via the fecal-oral route?
- A. A
- B. B
- C. C
- D. D
Correct Answer: A
Rationale: Hepatitis A is transmitted via the fecal-oral route, often through contaminated food or water, unlike B, C, and D, which are primarily bloodborne.
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Six months after starting disulfiram for treatment of alcoholism, the client has serum laboratory tests completed (see exhibit). Place an X on each serum laboratory result that the nurse should report immediately to the HCP.
- A. Potassium
- B. Albumin
- C. AST
- D. ALT
- E. Total bilirubin
- F. Alkanine Phosphatase
- G. RBCs
Correct Answer: B,C,DE,F
Rationale: Abnormal liver function tests (low albumin, elevated AST, ALT, total bilirubin, ALP) should be reported due to disulfiram's potential liver effects. [Image-based question; X on abnormal LFTs.]
A nurse teaching a patient with COPD pulmonary exercises should do which of the following?
- A. Teach pursed-lip breathing techniques.
- B. Encourage repetitive heavy lifting exercises that will increase strength.
- C. Limit exercises based on respiratory acidosis.
- D. Take breaks every 10-20 minutes with exercises.
Correct Answer: A
Rationale: Pursed-lip breathing will help decrease the volume of air expelled by increased bronchial airways.
The nurse applies a fentanyl transdermal patch to the client for the first time. Shortly after application, the client is experiencing pain. Which nursing action is most appropriate?
- A. Remove the transdermal patch and apply a new one.
- B. Administer a short-acting opioid analgesic medication.
- C. Rub the transdermal patch to enhance drug absorption.
- D. Call the HCP to request a higher-dosed fentanyl patch.
Correct Answer: B
Rationale: A: Removing the patch is unnecessary; effective analgesia may take 12 to 24 hours. B: The nurse should administer a short-acting opioid analgesic. When the first fentanyl (Duragesic) transdermal patch is applied, effective analgesia may take 12 to 24 hours because absorption is slow. C: Transdermal patches should not be rubbed to enhance absorption; it can cause the delivery of the medication to fluctuate. D: It is premature to request a higher dose of fentanyl.
The child, admitted to the ED, is experiencing nausea and vomiting, salivation, respiratory muscle weakness, and depressed reflexes an hour after exposure to pesticides. Which medications should the nurse anticipate administering to the child?
- A. Atropine and flumazenil
- B. Atropine and pralidoxime
- C. Epinephrine and naloxone
- D. Epinephrine and digoxin immune Fab
Correct Answer: B
Rationale: A: Flumazenil (Romazicon) antagonizes the effects of benzodiazepines on the CNS, such as sedation, impaired recall, and psychomotor impairment. B: An organophosphate base in pesticides causes acetylcholine to accumulate at neuromuscular junctions. Atropine (Atropine), an anticholinergic medication, and pralidoxime chloride (Protopam), a cholinesterase reactivator, are effective antidotes to reverse the symptoms. C: Epinephrine (EpiPen) is an alpha- and beta-adrenergic agonist and cardiac stimulant that strengthens myocardial contractions, increases systolic BP, increases cardiac rate and output, and constricts bronchial arterioles, inhibiting histamine release. Naloxone (Narcan) is a narcotic antagonist that reverses the effects of opiates. D: Digoxin immune Fab (Digibind) is the antidote for digoxin and digitoxin, which acts by complexing with circulating digoxin or digitoxin, preventing the drug from binding at receptor sites.
The parent of the 2-year-old with asthma has been given instructions about asthma control and Step Therapy. Which statement, if made by the parent, should indicate to the nurse that the parent has an adequate understanding of the instructions?
- A. If my child has wheezing twice a week or less, I should add the nebulized corticosteroid and make an appointment.
- B. If my child has a respiratory tract infection I should add the nebulized corticosteroid and make an appointment.
- C. If my child has to use the nebulizer less than twice a week, I should add the nebulized corticosteroid and make an appointment.
- D. If my child has nighttime awakenings with wheezing twice a month or more, I should add the nebulized corticosteroid and make an appointment.
Correct Answer: D
Rationale: A: Asthma symptoms (wheezing) occurring 2 or fewer days per week should be treated at Step 1. B: A respiratory tract infection may require the increased use of short-acting beta agonists, but an inhaled corticosteroid should not be added until the child is evaluated by the HCP. C: The use of the nebulizer twice a week or less should be treated at Step 1. D: Nighttime waking with asthma symptoms 1 to 2 times per month indicates the need to proceed to Step 2 therapy, which includes the use of an inhaled corticosteroid.