Nokea
You are providing care to a patient with COPD who is receiving medical treatment for exacerbation. The patient has a history of diabetes, hypertension, and hyperlipidemia. The patient is experiencing extreme hyperglycemia and bruising. Which medication ordered for this patient can cause hyperglycemia and bruising?
- A. Prednisone
- B. Atrovent
- C. Flagyl
- D. Levaquin
Correct Answer: A
Rationale: Prednisone , a corticosteroid, commonly causes hyperglycemia and easy bruising as side effects. Atrovent , Flagyl , and Levaquin are not typically associated with these effects.
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The post-anesthesia care nurse is caring for the client diagnosed with lung cancer who had a thoracotomy and is experiencing frequent premature ventricular contractions (PVCs). Which intervention should the nurse implement first?
- A. Request STAT arterial blood gases.
- B. Administer lidocaine intravenous push.
- C. Assess for possible causes.
- D. Request a STAT electrocardiogram.
Correct Answer: C
Rationale: Frequent PVCs post-thoracotomy may stem from hypoxia, electrolyte imbalances, or pain. Assessing for causes (C) is the first step to identify and address the underlying issue. ABGs (A) or ECG (D) may follow based on findings. Lidocaine (B) is premature without identifying the cause.
A patient is taking Streptomycin. Which finding below requires the nurse to notify the physician?
- A. Patient reports a change in vision.
- B. Patient reports a metallic taste in the mouth.
- C. The patient has ringing in their ears.
- D. The patient has a persistent dry cough.
Correct Answer: C
Rationale: Streptomycin can cause ototoxicity, leading to symptoms like ringing in the ears (tinnitus). This requires immediate physician notification to prevent further hearing damage.
The nurse is caring for the client diagnosed with pneumonia. Which information should the nurse include in the teaching plan? Select all that apply.
- A. Place the client on oxygen delivered by nasal cannula.
- B. Plan for periods of rest during activities of daily living.
- C. Place the client on a fluid restriction of 1,000 mL/day.
- D. Restrict the client's smoking to two (2) to three (3) cigarettes per day.
- E. Monitor the client's pulse oximetry readings every four (4) hours.
Correct Answer: B,E
Rationale: Rest periods (B) conserve energy, and pulse oximetry (E) monitors oxygenation in pneumonia. Oxygen (A) depends on SpO2, fluid restriction (C) is inappropriate, and smoking (D) must stop.
When the nurse is instructing the client on the effectiveness of oseltamivir (Tamiflu), which of the following instruction points is essential?
- A. Tamiflu must be started within 12 to 24 hours of the first symptoms.
- B. Tamiflu must be taken on an empty stomach to aid in absorption.
- C. Tamiflu affects the liver; liver enzymes are assessed before administration.
- D. Tamiflu is most effective when administered intranasally.
Correct Answer: A
Rationale: Oseltamivir is most effective when started within 12 to 24 hours of symptom onset, as it inhibits viral replication early.
To evaluate the significance of the client's bleeding, which additional assessment is most important for the nurse to make at this time?
- A. Count the pulse rate.
- B. Listen to heart sounds.
- C. Check the pupillary response.
- D. Measure the chest expansion.
Correct Answer: D
Rationale: Measuring chest expansion helps assess for complications like pneumothorax, which could cause bleeding post-bronchoscopy.