Nokea
While obtaining information about the client's current medication use, the nurse learns that the client takes ginkgo to improve mental alertness. The nurse should tell the client to:
- A. Report signs of bruising or bleeding to the doctor.
- B. Avoid sun exposure while using the herbal supplement.
- C. Purchase only those brands with FDA approval.
- D. Increase daily intake of vitamin E.
Correct Answer: A
Rationale: Ginkgo can increase bleeding risk by inhibiting platelet aggregation, so clients should report signs of bruising or bleeding to their doctor.
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A client with a history of breast cancer is admitted with complaints of lymphedema. The nurse should give priority to:
- A. Providing compression therapy
- B. Administering pain medication
- C. Monitoring blood pressure
- D. Administering chemotherapy
Correct Answer: A
Rationale: Compression therapy reduces swelling in lymphedema post-breast cancer, improving comfort and function.
Which one of the following is considered a reliable indicator for assessing the adequacy of fluid resuscitation in a 3-year-old child who suffered partial- and full-thickness burns to 25% of her body?
- A. Urine output
- B. Edema
- C. Hypertension
- D. Bulging fontanelle
Correct Answer: A
Rationale: Urinary output is a reliable indicator of renal perfusion, which in turn indicates that fluid resuscitation is adequate. IV fluids are adjusted based on the urinary output of the child during fluid resuscitation. Edema is an indication of increased capillary permeability following a burn injury. Hypertension is an indicator of fluid volume excess. Fontanelles close by 18 months of age.
The physician has ordered Dilantin (phenytoin) 100 mg intravenously for a client with generalized tonic clonic seizures. The nurse should administer the medication:
- A. Rapidly with an IV push
- B. With IV dextrose
- C. Slowly over 2-3 minutes
- D. Through a small vein
Correct Answer: C
Rationale: Phenytoin must be administered slowly (over 2-3 minutes) to prevent cardiovascular complications like hypotension or arrhythmias. It should not be mixed with dextrose or given rapidly.
The nurse is teaching a client with a history of osteoporosis about dietary modifications. The nurse should tell the client to increase intake of:
- A. Calcium-rich foods
- B. High-fiber foods
- C. Low-fat foods
- D. High-protein foods
Correct Answer: A
Rationale: Calcium-rich foods strengthen bones and help prevent further bone loss in osteoporosis, a critical dietary modification.
A 27-year-old primigravida at 32 weeks' gestation has been diagnosed with complete placenta previa. Conservative management including bed rest is the proper medical management. The goal for fetal survival is based on fetal lung maturity. The test used to determine fetal lung maturity is:
- A. Dinitrophenylhydrazine
- B. Metachromatic stain
- C. Blood serum phenylalanine test
- D. Lecithin-sphingomyelin ratio
Correct Answer: D
Rationale: Dinitrophenylhydrazine is a laboratory test used to detect phenylketonuria, maple syrup urine disease, and Lowe's syndrome. Metachromatic stain is a laboratory test that may be used to diagnose Tay-Sachs and other lipid diseases of the central nervous system. The blood serum phenylalanine test is diagnostic of phenylketonuria and can be used for wide-scale screening. A lecithin-sphingomyelin ratio of at least 2:1 is indicative of fetal lung maturity, and survival of the fetus is likely.