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A nurse in the ED is caring for a client reports a abdominal pain. Based
on the clients clinical findings which of the following actions should the
nurse take? - CORRECT ANSWER -assist the client to a left side
lying position with the right knee flexed
-administer a cleansing enema
-auscultate the clients bowel sounds
-perform a manual digital examination of the clients rectum
A nurse is caring for a client who had a spinal cord injury and has
paraplegia. The nurse is reviewing the clients medical record. Click to
highlight the findings that require intervention by the nurse. -
CORRECT ANSWER -passive range of motion exercises to
lower extremities performed weights each day
-plantar flexion contractures noted bilaterally
-left heel with 1.3 cm x 1.3 cm area of non-blanchable arrhythmia, skin
intact
The nurse is caring for a client who has a peripheral IV inserted or fluid
replacement. The nurse is assessing a client. Which of the following
action should the nurse take? - CORRECT ANSWER -stop the
IV infusion
-elevate the client left arm
-apply heat to the client left hand
The nurse is caring for a client who has COPD. Select the three findings
that require follow up. - CORRECT ANSWER -breath sounds
-temperature
,-oxygen saturation
a nurse is caring for a client who is receiving morphine, what
assessment is priority - CORRECT ANSWER RR
a nurse is assessing a client who has been using beclomethasone for 2
weeks to manage her asthma, what is the priority to report to the
provider - CORRECT ANSWER bronchospasms
a nurse is caring for a client who has prescription for terazosin, the
nurse should identify that this medication is indicated for which of the
following disorders? - CORRECT ANSWER hypertension
BPH
a nurse is providing teaching to a client who has a new prescription for
beclomethasone inhaler to use with an albuterol inhaler for asthma
maintenance, what should the nurse instruct? - CORRECT
ANSWER you should gargle with water after each use of this
inhaler
a nurse is preparing to administer topotecan IV, which of the following
meds should the nurse expect to administer to control the adverse
effects - CORRECT ANSWER granisetron
(antiemetic to prevent n/v) for clients receiving chemo
a nurse is planning a staff education session on AE of meds, what info
should the nurse discuss about anticholinergic adverse effects? -
CORRECT ANSWER blurred vision
tachycardia
constipation
,a nurse is providing teaching to a client who has a new prescription for
guaifenesin, what info regarding the action of guaifenesin should the
nurse include in the teaching? - CORRECT ANSWER
guaifenesin increases cough production
a nurse is preparing to administer verapamil to a client who is 2 days
postmyocardial infarction. the nurse should monitor the client for
which of the following outcomes as therapeutic response to the
medication? - CORRECT ANSWER decreased anginal pain
a nurse is providing teaching to a client who has a new prescription for
levothyroxine, which statement indicates understanding of the
teaching? - CORRECT ANSWER "i might not realize the full
effect of the medication for several weeks"
take on empty stomach with glass of water, first thing in the morning
30-60min prior to breakfast
a nurse is assessing a client who has HF is taking digoxin. the nurse
should monitor the client for which of the following manifestations as
an indication of digoxin toxicity to report to the provider? -
CORRECT ANSWER vomiting
(n/v, anorexia, blurred vision)
a nurse is providing teaching for a pt with a prescription for oral
metronidazole, what is the priority teaching point? - CORRECT
ANSWER you should report a rash to your provider
(fatal disorder Stevens-Johnson syndrome)
, a nurse is providing discharge instructions to a client who has a new
prescription for codeine for cough suppression, what is the priority
instruction? - CORRECT ANSWER move slowly when standing
from a lying down position
(r/f orthostatic hypotension)
a nurse is reviewing the medical record of a client who received his
medications 1 hour ago, the pt reports chest pain, this can be an AE of
what med? - CORRECT ANSWER albuterol
(beta2agonist, controls bronchospasm for asthma--can cause tremors,
chest pain, tachycardia, dysrhythmias)
a nurse is teaching a pt who has a new prescription for brimonidine to
treat open-angle glaucoma, what indicates an understanding of the
instructions? - CORRECT ANSWER i can expect to feel some
irritation when i put these drops in my eyes
a nurse is caring for a female client who has osteoporosis and a new
prescription for raloxifene, what should the nurse assess prior to
initiating therapy? - CORRECT ANSWER pregnancy status
(risk category X)
a nurse is teaching a pt to use TD nitroglycerin patches to treat angina
pectoris, what instructions should she include? - CORRECT
ANSWER apply a new patch every morning
(effects begin 30-60 min after application and last 14 hours)