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Questions 148

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Question 1 of 5

A client with preeclampsia has been receiving an infusion containing magnesium sulfate for a blood pressure that is 160/80; deep tendon reflexes are 1 plus, and the urinary output for the past hour is 100 mL. The nurse should:

Correct Answer: A

Rationale: The parameters (BP 160/80, 1+ reflexes, 100 mL urine output) are within acceptable limits, so the infusion should continue.

Question 2 of 5

Which statement by the client regarding sickle cell disease indicates a need for further teaching?

Correct Answer: B

Rationale: Alcohol, including red wine, can cause dehydration and increase the risk of sickle cell crisis, so it should be avoided. Other statements are correct.

Question 3 of 5

The nurse is preparing to administer a dose of warfarin (Coumadin) to a client. The client’s international normalized ratio (INR) is 4.5. Which of the following actions should the nurse take?

Correct Answer: B

Rationale: an INR of 4.5 is above the therapeutic range (2.0–3.0), indicating a risk of bleeding; the dose should be withheld and the physician notified

Question 4 of 5

A client comes into the emergency room after a chemical splashed into her eye at work. The priority nursing intervention is to

Correct Answer: C

Rationale: Immediate irrigation with saline removes the chemical, preventing further eye damage. Other actions follow after irrigation.

Question 5 of 5

The doctor has prescribed aspirin 325 mg daily for a client with transient ischemic attacks. The nurse explains that aspirin was prescribed to:

Correct Answer: D

Rationale: Aspirin inhibits platelet aggregation, reducing the risk of clot formation in transient ischemic attacks, which are precursors to stroke.

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