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Question 1 of 5

A client in the ICU is given procainamide HCl (Pronestyl) slowly IV push. The nurse should withhold the next dose if which of the following was observed?

Correct Answer: B

Rationale: Procainamide treats ventricular and atrial arrhythmias, but severe hypotension is an adverse reaction requiring the dose to be withheld. PVCs (
A) and atrial tachycardia (
C) are indications for use, and a normal sedimentation rate (
D) is irrelevant.

Question 2 of 5

A client with mastoiditis has a left mastoidectomy with tympanoplasty. The nurse should observe the client for signs of damage to the sixth crania nerve, which include:

Correct Answer: B

Rationale: The sixth cranial nerve (abducens) controls lateral eye movement, so damage would result in an inability to look laterally.

Question 3 of 5

The nurse is caring for a client who had knee surgery this morning. Postoperative orders include a narcotic every three to four hours as needed for operative site pain and an ice bag. At 7:00 P.M., the client asks for pain medication. He was last medicated at 3:30 P.M. What is the best initial nursing action?

Correct Answer: B

Rationale: Assessing pain location and nature ensures the medication is appropriate for operative site pain, guiding safe administration. Administering without assessment, refilling ice, or repositioning are premature.

Question 4 of 5

The nurse is caring for a client with a spinal cord injury at the T4 level. Which of the following findings would be MOST concerning?

Correct Answer: A

Rationale: A T4 spinal cord injury can cause autonomic dysreflexia or neurogenic shock, leading to severe hypotension (80/50) and bradycardia (pulse 50), which are life-threatening and require immediate intervention. Low-grade fever (
B), spasticity (
C), and numbness (
D) are expected or less urgent.

Question 5 of 5

A client has returned to his room following an esophagoscopy. Before offering fluids, the nurse should give priority to assessing the client's:

Correct Answer: B

Rationale: Assessing the gag reflex is critical post-esophagoscopy to ensure the client can swallow safely, as local anesthesia may impair this reflex.

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