Nursing Elites

1. The nurse is planning care for a client with cirrhosis of the liver. Which intervention should the nurse include to reduce the risk of bleeding?

• A. Monitor for signs of infection.
• B. Limit the client's dietary protein intake.
• C. Administer vitamin K as prescribed.
• D. Encourage the client to increase fluid intake.

Correct answer: C

Rationale: Administering vitamin K as prescribed can help reduce the risk of bleeding in clients with cirrhosis by promoting clotting factor production. Cirrhosis often leads to impaired liver function, affecting the synthesis of clotting factors. Vitamin K supplementation helps in the production of these essential clotting factors, thus reducing the risk of bleeding in clients with cirrhosis. Monitoring for signs of infection (Choice A) is important for overall care but not directly related to reducing the risk of bleeding in cirrhosis. Limiting dietary protein intake (Choice B) may be necessary in some cases of cirrhosis but does not directly address the risk of bleeding. Encouraging increased fluid intake (Choice D) is beneficial for various aspects of health but does not specifically target the risk of bleeding in cirrhosis.

2. A client with a new diagnosis of myasthenia gravis is prescribed pyridostigmine (Mestinon). Which instruction should the nurse include in the client's teaching?

• A. Take the medication with food to prevent gastrointestinal upset.
• B. Take the medication 30 minutes before meals.
• C. Avoid dairy products while taking this medication.
• D. Take the medication at bedtime.

Correct answer: B

Rationale: The correct instruction for a client with myasthenia gravis prescribed pyridostigmine (Mestinon) is to take the medication 30 minutes before meals. This timing is crucial as it helps improve muscle strength for eating and swallowing. By taking the medication before meals, the client can experience enhanced muscle function during mealtime, which is especially important for managing the symptoms of myasthenia gravis. Choices A, C, and D are incorrect. Taking the medication with food may decrease its effectiveness, avoiding dairy products is not necessary, and taking the medication at bedtime does not coincide with the optimal timing for enhancing muscle function during meals.

3. A 56-year-old woman with rheumatoid arthritis has severe joint pain and swelling in her hands. She has a history of peptic ulcer disease five years ago but presently has no GI symptoms. You elect to start her on an NSAID. Which of the following is correct?

• A. Proton-pump inhibitors and H2-blockers are equally effective in prophylaxis against NSAID-related GI toxicity.
• B. Misoprostol is superior to an H2-blocker in prophylaxis against NSAID-related GI toxicity.
• C. Sucralfate is not the drug of choice for prophylaxis in this patient.
• D. H. pylori infection can alter the risk for an NSAID-induced ulcer.

Correct answer: B

Rationale: In this scenario, the patient's history of peptic ulcer disease puts her at risk for NSAID-related GI toxicity. Misoprostol and proton-pump inhibitors have shown superiority over H2-blockers in preventing NSAID-related GI toxicity. H. pylori infection can indeed increase the risk of an NSAID-induced ulcer in infected patients who are starting NSAID therapy. Sucralfate has not been proven to be effective in prophylaxis against NSAID-related GI toxicity. Therefore, the correct choice is B, as misoprostol is the preferred option over an H2-blocker in this context.

4. What nursing intervention can help alleviate pruritus in a client with cirrhosis?

• A. Administering antihistamines
• B. Providing a high-protein diet
• C. Applying emollients to the skin
• D. Encouraging frequent baths with hot water

Correct answer: C

Rationale: Applying emollients to the skin can help alleviate pruritus in clients with cirrhosis. Emollients help soothe and moisturize the skin, reducing the discomfort associated with itching.

5. The healthcare provider prescribes 15 mg/kg of Streptomycin for an infant weighing 4 pounds. The drug is diluted in 25 ml of D5W to run over 8 hours. How much Streptomycin will the infant receive?

• A. 9 mg
• B. 18 mg
• C. 27 mg
• D. 36 mg

Correct answer: A

Rationale: To calculate the dosage, first, convert the weight from pounds to kg (4 lbs / 2.2 ≈ 1.82 kg). Then, multiply by the prescribed mg/kg (15 mg/kg * 1.82 kg ≈ 27.3 mg). However, since the question asks for the closest correct option, the infant will receive approximately 9 mg.

Similar Questions