Nokea
Your patient, who is receiving Pyrazinamide, report stiffness and extreme pain in the right big toe. The site is extremely red, swollen, and warm. You notify the physician and as the nurse you anticipated the doctor will order?
- A. Calcium level
- B. Vitamin B6 level
- C. Uric acid level
- D. Amylase level
Correct Answer: C
Rationale: Pyrazinamide can cause hyperuricemia, leading to gout symptoms (pain, redness, swelling in joints like the big toe). The physician will likely order a uric acid level to confirm this side effect.
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When suctioning a client with a tracheostomy, when is the best time to occlude the vent on the suction catheter?
- A. Before inserting the catheter
- B. When inside the inner cannula
- C. While withdrawing the catheter
- D. When the client begins coughing
Correct Answer: C
Rationale: Occluding the vent while withdrawing the catheter applies suction to remove secretions effectively.
The client diagnosed with chronic sinusitis who has undergone a Caldwell-Luc procedure is complaining of pain. Which intervention should the nurse implement first?
- A. Administer the narcotic analgesic intravenous push (IVP).
- B. Perform gentle oral hygiene.
- C. Place the client in semi-Fowler's position.
- D. Assess the client's pain.
Correct Answer: D
Rationale: Pain assessment (D) is the first step to determine severity and guide treatment. Narcotics (A), oral hygiene (B), and positioning (C) follow based on assessment.
Which instruction regarding the prescribed medication is most appropriate to tell this client?
- A. Do not take the drug more frequently than prescribed.
- B. Avoid taking the medication before going to sleep.
- C. Drink more fluid throughout the day.
- D. Warm the cough syrup to make it more palatable.
Correct Answer: C
Rationale: Drinking more fluids enhances the expectorant effect of guaifenesin, helping to thin and expel mucus.
The nurse and an unlicensed assistive personnel (UAP) are caring for a group of clients on a medical unit. Which information provided by the UAP warrants immediate intervention by the nurse?
- A. The client diagnosed with cancer of the lung has a small amount of blood in the sputum collection cup.
- B. The client diagnosed with chronic emphysema is sitting on the side of the bed and leaning over the bedside table.
- C. The client receiving Procrit, a biologic response modifier, has a T 99.2°F, P 68, R 24, and BP of 198/102.
- D. The client receiving prednisone, a steroid, is complaining of an upset stomach after eating breakfast.
Correct Answer: C
Rationale: Hypertension (198/102) with Procrit (C) suggests a serious side effect, requiring immediate intervention. Hemoptysis (A), tripod position (B), and stomach upset (D) are expected or less urgent.
The nurse is assessing the client diagnosed with COPD. Which data require immediate intervention by the nurse?
- A. Large amounts of thick white sputum.
- B. Oxygen flowmeter set on eight (8) liters.
- C. Use of accessory muscles during inspiration.
- D. Presence of a barrel chest and dyspnea.
Correct Answer: B
Rationale: High oxygen (8 LPM, B) risks CO2 retention in COPD, requiring immediate adjustment (2–4 LPM). Sputum (A), accessory muscles (C), and barrel chest (D) are expected but less urgent.