A client is suspected of having a myocardial infarction. The nurse should expect
elevations in which isoenzyme value reported with the creatine kinase (CK) level?
Give this one a try later!
MB
Rationale:
The MB band reflects CK from cardiac muscle, which is the level that
increases with myocardial infarction. The MM band reflects CK from
skeletal muscle. The BB band reflects CK from the brain. There is no MK
band.
A client is scheduled for an oral cholecystography. The nurse should plan to obtain
what type of diet for the evening meal before the test?
Give this one a try later!
, Fat-free
Rationale:
Normal dietary intake of fat should be maintained during the days
preceding the test in order to empty bile from the gallbladder. A fat-free
diet is prescribed on the evening before the test. The fat-free supper
prevents contraction of the gallbladder and allows accumulation of the
contrast substance needed for x-ray visualization. Options 1, 3, and 4 are
incorrect.
The nurse has given a client taking ethambutol (Myambutol) information about the
medication. The nurse determines that the client understands the instructions if the
client states to report which occurrence immediately?
Give this one a try later!
Problems with visual acuity
Rationale:
Ethambutol (Myambutol) causes optic neuritis, which decreases visual
acuity and the ability to discriminate between the colors red and green. This
poses a potential safety hazard when a client is driving a motor vehicle. The
client is taught to report this symptom immediately. The client is also taught
to take the medication with food if GI upset occurs. Impaired hearing
results from antitubercular therapy with streptomycin. Red-orange
discoloration of secretions occurs with rifampin (Rifadin).
The nurse removes the dressing on a client's heel that is covering a pressure sore one-
inch in diameter and finds that there is straw-colored drainage seeping from the
wound. What description of this finding should the nurse include in the client's
record?
Give this one a try later!
, One-inch pressure sore draining serous fluid.
The licensed practical nurse is assisting in the admittance of a client who has been
involuntarily committed to the behavioral health unit. Which actions by the client
before hospitalization led to the commitment? Select all that apply.
Give this one a try later!
Client threatened to commit suicide
Client threatened to kidnap his spouse.
Rationale:
Involuntary admission criteria include imminent danger to self or others and
the inability to care for one's own basic needs. Threatening to commit
suicide and kidnapping one's spouse meet these criteria. Not bathing in 2
days and not taking antipsychotic medications reflect the client's autonomy
in self-care and writing a document in chalk on the sidewalk is eccentric
but presents no danger to the client or others.
The nurse reviews the client's serum calcium level and notes that the level is 8.0
mg/dL. The nurse understands which condition causes this serum calcium level?
Give this one a try later!
, Prolonged bed rest
Rationale:
The normal serum calcium level is 8.6 to 10.0 mg/dL. A client with a serum
calcium level of 8.0 mg/dL is experiencing hypocalcemia. The excessive
ingestion of vitamin D, adrenal insufficiency, and hyperparathyroidism are
causative factors associated with hypercalcemia. Although immobilization
can initially cause hypercalcemia, the long-term effect of prolonged
bedrest is hypocalcemia.
The nurse is preparing to give a client dehydration IV fluids delivered at a continuous
rate of 175 ml/hour. Which infusion device should the nurse use?
Give this one a try later!
Cassette infusion pump.
A client with human immunodeficiency virus is taking nevirapine (Viramune). The nurse
should monitor for which side/adverse effects of the medication? Select all that apply.
Give this one a try later!
Rash
Hepatotoxicity
Nevirapine (Viramune) is a nonnucleoside reverse transcriptase inhibitor
that is used to treat HIV infection. It is used in combination with other
antiretroviral medications to treat HIV. Adverse effects include rash,
Stevens-Johnson syndrome, hepatitis, and increased transaminase levels.
Hyperglycemia, peripheral neuropathy, and reduced bone density are not
side/adverse effects of this medication.
elevations in which isoenzyme value reported with the creatine kinase (CK) level?
Give this one a try later!
MB
Rationale:
The MB band reflects CK from cardiac muscle, which is the level that
increases with myocardial infarction. The MM band reflects CK from
skeletal muscle. The BB band reflects CK from the brain. There is no MK
band.
A client is scheduled for an oral cholecystography. The nurse should plan to obtain
what type of diet for the evening meal before the test?
Give this one a try later!
, Fat-free
Rationale:
Normal dietary intake of fat should be maintained during the days
preceding the test in order to empty bile from the gallbladder. A fat-free
diet is prescribed on the evening before the test. The fat-free supper
prevents contraction of the gallbladder and allows accumulation of the
contrast substance needed for x-ray visualization. Options 1, 3, and 4 are
incorrect.
The nurse has given a client taking ethambutol (Myambutol) information about the
medication. The nurse determines that the client understands the instructions if the
client states to report which occurrence immediately?
Give this one a try later!
Problems with visual acuity
Rationale:
Ethambutol (Myambutol) causes optic neuritis, which decreases visual
acuity and the ability to discriminate between the colors red and green. This
poses a potential safety hazard when a client is driving a motor vehicle. The
client is taught to report this symptom immediately. The client is also taught
to take the medication with food if GI upset occurs. Impaired hearing
results from antitubercular therapy with streptomycin. Red-orange
discoloration of secretions occurs with rifampin (Rifadin).
The nurse removes the dressing on a client's heel that is covering a pressure sore one-
inch in diameter and finds that there is straw-colored drainage seeping from the
wound. What description of this finding should the nurse include in the client's
record?
Give this one a try later!
, One-inch pressure sore draining serous fluid.
The licensed practical nurse is assisting in the admittance of a client who has been
involuntarily committed to the behavioral health unit. Which actions by the client
before hospitalization led to the commitment? Select all that apply.
Give this one a try later!
Client threatened to commit suicide
Client threatened to kidnap his spouse.
Rationale:
Involuntary admission criteria include imminent danger to self or others and
the inability to care for one's own basic needs. Threatening to commit
suicide and kidnapping one's spouse meet these criteria. Not bathing in 2
days and not taking antipsychotic medications reflect the client's autonomy
in self-care and writing a document in chalk on the sidewalk is eccentric
but presents no danger to the client or others.
The nurse reviews the client's serum calcium level and notes that the level is 8.0
mg/dL. The nurse understands which condition causes this serum calcium level?
Give this one a try later!
, Prolonged bed rest
Rationale:
The normal serum calcium level is 8.6 to 10.0 mg/dL. A client with a serum
calcium level of 8.0 mg/dL is experiencing hypocalcemia. The excessive
ingestion of vitamin D, adrenal insufficiency, and hyperparathyroidism are
causative factors associated with hypercalcemia. Although immobilization
can initially cause hypercalcemia, the long-term effect of prolonged
bedrest is hypocalcemia.
The nurse is preparing to give a client dehydration IV fluids delivered at a continuous
rate of 175 ml/hour. Which infusion device should the nurse use?
Give this one a try later!
Cassette infusion pump.
A client with human immunodeficiency virus is taking nevirapine (Viramune). The nurse
should monitor for which side/adverse effects of the medication? Select all that apply.
Give this one a try later!
Rash
Hepatotoxicity
Nevirapine (Viramune) is a nonnucleoside reverse transcriptase inhibitor
that is used to treat HIV infection. It is used in combination with other
antiretroviral medications to treat HIV. Adverse effects include rash,
Stevens-Johnson syndrome, hepatitis, and increased transaminase levels.
Hyperglycemia, peripheral neuropathy, and reduced bone density are not
side/adverse effects of this medication.
