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Questions 148

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Extract:


Question 1 of 5

A client being treated with sodium warfarin has an INR of 8.0. Which intervention would be most important to include in the nursing care plan?

Correct Answer: A

Rationale: An INR of 8.0 indicates a high risk of bleeding, so assessing for abnormal bleeding is the priority intervention.

Question 2 of 5

A client admitted for treatment of bacterial pneumonia has an order for intravenous ampicillin. Which specimen should be obtained prior to administering the medication?

Correct Answer: D

Rationale: A sputum culture and sensitivity should be obtained before starting antibiotics to identify the causative organism and ensure appropriate treatment.

Question 3 of 5

The nurse is monitoring the labs of a client admitted with viral hepatitis. Which of the following lab findings would the nurse expect for this client? Select all that apply.

Correct Answer: B, C, D

Rationale: Viral hepatitis typically causes increased AST, elevated ammonia, and low serum albumin due to liver damage, while ALT is usually increased, not decreased, and prothrombin time is prolonged.

Question 4 of 5

An obstetrical client calls the clinic with complaints of morning sickness. The nurse should tell the client to:

Correct Answer: A

Rationale: Eating crackers before getting out of bed stabilizes stomach acid and blood sugar, reducing morning sickness.

Question 5 of 5

A 4-year-old is admitted with acute leukemia. It will be most important to monitor the child for:

Correct Answer: C

Rationale: Acute leukemia causes bone marrow suppression, leading to anemia (pallor) and thrombocytopenia (bleeding), which are critical to monitor.

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