The nurse is administering Dilantin (phenytoin) via nasogastric (NG) tube. When giving the medication, the nurse should:
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Solution
Answer D is correct. The nurse should flush the NG tube with 2–4oz. of water before and after giving the medication. Answers A and B are incorrect because they do not use sufficient amounts of water. Answer C is incorrect because water, not normal saline, is used to flush the NG tube.
The nurse is preparing a client with gastroesophageal reflux disease (GERD) for discharge. The nurse should tell the client to:
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Solution
Answer C is correct. The client with gastroesophageal reflux disease (GERD) should avoid beverages containing caffeine because they increase the production of hydrochloric acid, which erodes the esophagus. Answer A is incorrect because the client should not eat for 3–4 hours before going to bed. The client should sleep on his left side, not his right side; therefore, answer B is incorrect. Citrus juices are acidic, which can contribute to reflux and esophageal erosion; therefore, answer D is incorrect.
The nurse is teaching the parents of an infant with osteogenesis imperfecta. The nurse should explain the need for:
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Solution
Answer B is correct. The infant with osteogenesis imperfecta (ribbon bones) should be handled with care to prevent fractures. Adding calcium to the infant’s diet will not improve the condition; therefore, answer A is incorrect. Answers C and D are not related to the disorder; therefore, they are incorrect.
The nurse is caring for an infant who is on strict intake and output. The used diaper weighs 90.5 grams. The diaper’s dry weight was 62 grams. The infant’s urine output was:
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Solution
Answer B is correct. To obtain the urine output, the weight of the dry diaper (62 grams) is subtracted from the weight of the used diaper (90.5 grams), for a urine output of 28.5 grams, or 28.5mL (1 gram = 1mL). Answer A is an inaccurate amount; therefore, it is incorrect. Output is measured in milliliters, not grams; therefore, answers C and D are incorrect.
The physician has prescribed nitroglycerin buccal tablets as needed for a client with angina. The nurse should tell the client to take the tablets:
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Solution
Answer C is correct. Nitrogycerin tablets should be used as soon as the client first notices chest pain or discomfort. Answer A is incorrect because the medication should be used before engaging in activity. Strenuous activity should be avoided. Answer B is incorrect because the medication should be used when pain occurs, not on a regular schedule. Answer D is incorrect because the medication will not prevent nocturnal angina.
A client is admitted for suspected bladder cancer. Which one of the following factors is most significant in the client’s diagnosis?
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Solution
Answer A is correct. Cigarette smoking is the number one cause of bladder cancer. Answer B is incorrect because it is associated with breast cancer, not bladder cancer. Answer C is wrong because it is a primary cause of gastric cancer. Answer D is incorrect because it is a cause of certain types of lung cancer.
To reduce the possibility of having a baby with a neural tube defect, the client should be told to increase her intake of folic acid. Dietary sources of folic acid include:
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Solution
Answer C is correct. Dark-green, leafy vegetables; the cabbage family; beets; kidney beans; cantaloupe; and oranges are good sources of folic acid (B9). Meat, liver, eggs, dried beans, sweet potatoes, and Brussels sprouts are good sources of B12; therefore, answers A and D are incorrect. Pork, fish, and chicken are good sources of B6; therefore, answer B is incorrect.
A hospitalized client with severe anemia is to receive a unit of blood. Which facet of care is most appropriate for the newly licensed practical nurse?
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Solution
Answer B is correct. The most appropriate facet of care for the newly licensed practical nurse is the monitoring of the client’s vital signs. Answers A and C are incorrect because initiation of IV fluids and administration of blood is the responsibility of the registered nurse. Answer D is incorrect because in the hospital setting, the registered nurse would be responsible for notifying the physician of a reaction.
Which of the following clients is most likely to be a victim of elder abuse?
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Solution
Answer B is correct. Females with chronic debilitating conditions who are dependent on others for most or all of their care are most likely to be the victims of elder abuse. Answers A, C, and D are incorrect because the clients are less likely to be dependent on others for their care; therefore, they are less likely to be victims of elder abuse. Although they might also be victims, men are less likely to report abuse than women.
The mother of a child with chickenpox wants to know if there is a medication that will shorten the course of the illness. Which medication is sometimes used to speed healing of the lesions and shorten the duration of fever and itching?
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Solution
Answer A is correct. Acyclovir shortens the course of chickenpox, but the American Academy of Pediatrics does not recommend it for healthy children because of the cost. Answer B is incorrect because it is the vaccine used to prevent chickenpox. Answer C is incorrect because it is the immune globulin given to those who have been exposed to chickenpox. Answer D is incorrect because it is an antihistamine used to control itching associated with chickenpox.