Myocardial infarction
A client who had a myocardial infarction is admitted to the coronary critical care unit (CCU) with a nitroglycerin drip infusing. The clients last blood pressure measurements was 78/36.What action should the nurse implement?
a. obtain blood pressure q5 minutes using duranap machine
b. change the dilution of the nytroglycerin infusion c. reduce the rate of the nitroglycerin infusion
d. begin dopamine infusion at 5mcg/kg per minute
An adolescent is admitted to the hospital because of a suicide attempt with an overdose of acetaminophen (Tylenol). Which blood values are most important for the nurse to monitor during the first 72 hours following ingestion of this overdose?
e. BUN creatinine specific gravity
f. White blood count, hemoglobin hematocrit
g. PH,PCO2, HC03
h. LDH OR LD, SGOT OR ALT, SGPT OR AST.
An elderly post operative female client is receiving morphine sulfate via a PCA pump. Which assessment finding should prompt a nurse to administer the prescribed PRN medication naloxone?
i. her respiratory rate is 7 breath/minute
j. she indicates that she feels as if she cannot get enough air to breath
k. she has intercostal retractions and bilateral wheezing is auscultated
l. her pulse oximeter is 89% on room air
Which assessment finding indicates to the nurse that the muscarinic agent bethanechol (Urecholine) is effective for a client diagnose with urinary retention?
a. urinary output equal to intake
b. no terminal urinary dribbling
c. denies stress incontinence
d. absence of xerostomia
Following involvement in a motor vehicle collision, a middle aged adult client is admitted to the hospital with multiple facial fractures. The clients blood alcohol level is high on admission. Which PRN prescription should be administer if the clients begins to exhibit signs and symptoms of delirium tremens (DT s)?
a. Lorazepam (Ativan) 2mg IM
b. Chlorpromazine (thorazine) 50 mg IM
c. Prochlorperazine (Compazine) 5 mg IM
d. Hydromorphone (Dilaudid) 2 mg IM
Which instructions should the nurse include in the teaching plan of a client who is taking the diuretic spironolactone (Aldactone)?
a. call the healthcare provider f you develop gynecomastia b. Take the medication in the morning
c. Avoid caffeine and smoking
d. Increase your consumption of bananas and oranges
A glucagon emergency kit is prescribed for a client with type 1 diabetes mellitus. When should the nurse instruct the client to take the glucagon?
a. after meals to increase endogenous insulin secretion
b. after insulin administration to prevent hypoglycemia c. when recognized signs of severe hypoglycemia occur
d. when unable to eat during sick days
A client with hyperthyroidism is being treated with radioactive iodine (I-131). Which explanation should be included in preparing this client for this treatment?
e. describe radioactive iodine as a tasteless, colorless medication administered by the healthcare provider
f. explain the need for using lead shields for 2 to 3 weeks after the treatment
g. describe the signs of goiter because this is a common side effects of radioactive iodine
h. explain that relief of the signs/ symptoms of hyperthyroidism will occur immediately
A female client is being treated for tuberculosis with rifampin (rifadin) Which statement indicates that futher teaching is needed?
d- I will take my usual contraceptive for birth control
A client is discharged with a prescription for warfarin ( Coumadin). What discharge instructions should the nurse emphasize to the client?
a. take a multi vitamin supplement daily
b. use an astringent for superficial bleeding c. avoid going barefoot especially outside
d. include large amounts of spinach in the diet
In caring for a client with diabetes insipidus who is receiving an antidiuretic hormone intranasally which serum lab test is most important for the nurse to monitor?
e. osmolality
f. calcium
g. platelets
h. glucose
