Question

A nurse is preparing a client who is to receive chemotherapy for treatment of ovarian cancer. Which of the following actions should the nurse plan to take?

Answer 1

Correct Answers:

Administer an antiemetic prior to the procedure.

Rationale :

Chemotherapy often induces nausea and vomiting due to its effects on rapidly dividing cells, including those in the gastrointestinal tract. Administering an antiemetic before treatment helps prevent this side effect, improving the client’s comfort and nutritional status.

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Answer 2

Correct Answers:

Assess for dislodgement and use forceps to retrieve the dislodged pellets and place in the lead container.

Rationale :

Brachytherapy involves radioactive implants; dislodgement poses immediate radiation exposure risks. The nurse’s priority is to safely retrieve and contain the pellets using proper shielding (lead container) to protect the patient and staff. This action aligns with radiation safety protocols to minimize contamination.

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Answer 3

Correct Answers:

Remove circulating antibodies from the blood stream

Rationale :

Plasmapheresis treats autoimmune conditions like multiple sclerosis by filtering pathogenic antibodies from the blood. It does not address fluid overload or protein levels but directly targets the autoimmune attack on the myelin sheath. This intervention helps mitigate disease progression and symptom severity.

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Answer 4

Correct Answers:

Prepare for synchronize cardioversion

Rationale :

The patient’s unstable vitals (hypotension, tachycardia) indicate a perfusing but life-threatening arrhythmia (e.g., ventricular tachycardia). Synchronized cardioversion is the first-line treatment to restore normal rhythm while minimizing myocardial damage. Immediate intervention is critical to prevent cardiac arrest.

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Answer 5

Correct Answers:

Associated with recent vaccination
Associated with exposure to a recent viral infection

Rationale :

Guillain-Barré syndrome (GBS) is often triggered by an immune response to infections (e.g., Campylobacter, influenza) or vaccinations. These events precede the autoimmune attack on peripheral nerves. Other options (tobacco use, surgery) lack strong evidence as direct triggers.

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Answer 6

Correct Answers:

Orthostatic hypotension

Rationale :

Carbidopa-levodopa affects dopamine levels, which can disrupt autonomic regulation of blood pressure, leading to orthostatic hypotension. This side effect increases fall risk, requiring careful monitoring. Other options (jaundice, hyperglycemia) are not typical of this medication.

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Answer 7

Correct Answers:

Administration of morphine for pain

Rationale :

LPNs are licensed to administer medications, including opioids, under RN supervision. Tasks like discharge teaching or blood product administration require advanced assessment skills outside their scope. Pain management is a routine and appropriate LPN responsibility.

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Answer 8

Correct Answers:

Administering oral antibiotics to a client with UTI.

Rationale :

LPNs can safely administer oral medications, a routine and low-risk task. Complex assessments (e.g., evaluating dialysis outflow) or patient education require RN-level critical thinking. Delegation should align with the LPN’s defined competencies.

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Answer 9

Correct Answers:

Administer an additional rescue dose of Albuterol

Rationale :

A peak flow reading of 82% signals moderate asthma exacerbation, requiring immediate bronchodilator use. Rescue inhalers (e.g., albuterol) are first-line for symptom relief. Emergency care is reserved for severe drops (<50%) or failure to improve.

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Answer 10

Correct Answers:

Peaked T waves

Rationale :

Hyperkalemia causes distinct EKG changes, with peaked T waves being the earliest and most recognizable sign. This reflects altered cardiac repolarization due to elevated potassium. Other changes (widened QRS, absent P waves) occur later.

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RN medsurg II Nur 201

No.

1 : A nurse is preparing a client who is to receive chemotherapy for treatment of ovarian cancer. Which of the following actions should the nurse plan to take?

2 : The nurse is caring for a client with uterine cancer who is being treated with brachytherapy. The I-JAP reports that the client ambulated to the restroom and is now reporting, "Something feels like it's coming out." What is the nurse's priority action?

3 : A client with a diagnosis of multiple sclerosis is scheduled to receive plasmapheresis treatments. A nurse explains to the client's spouse that the purpose of plasmapheresis is to:

5 : A nurse is caring for a client that has been recently diagnosed with Guillian-Barre syndrome. What would the nurse consider to be common risk factors associated with Guillain-Barré syndrome (GBS)? (select all that apply.)

6 : A client with Parkinson's disease is prescribed carbidopa-levodopa [Sinemet]. Which of the following side effects does the nurse recognize can occur with this medication?

7 : The nurse working in the Neuro ICU is caring for a client with Guillain-Barré syndrome. Which of the following activities would be best assigned to the Licensed practical nurse (LPN)?

8 : A nurse is caring for a group of clients on a hospital unit with the assistance of a licensed practical nurse [LPN]. Which aspect of client care would be the most appropriate for the nurse to delegate to the LPN?

9 : A nurse instructs a 60-year-old client diagnosed with asthma about using a peak expiratory flow meter. Which immediate action should the nurse recommend to the client that obtains a reading of 82% on their peak flow meter?

10 : A nurse is reviewing the EKG strip of a client who is hypertensive and is complaining of muscle weakness. Which of the following abnormalities on the client's EKG should the nurse interpret as a sign of hyperkalemia?

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