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Questions 158

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Question 1 of 5

A pregnant client experiences spontaneous rupture of membranes. The first nursing action is to:

Correct Answer: C

Rationale: Auscultating fetal heart rate is critical after membrane rupture to assess for cord prolapse, a potential complication.

Question 2 of 5

A client has developed diabetes insipidus after removal of a pituitary tumor. Which finding would the nurse expect?

Correct Answer: A

Rationale: Diabetes insipidus causes polyuria due to deficient antidiuretic hormone, leading to excessive water loss. Hypertension (
B), polyphagia (
C), and hyperkalemia (
D) are not typical.

Question 3 of 5

A client is being treated for congestive heart failure. His medical regimen consists of digoxin (Lanoxin) 0.25 mg po daily and furosemide 20 mg po bid. Which laboratory test should the nurse monitor?

Correct Answer: C

Rationale: Furosemide is a nonpotassium-sparing loop diuretic. Hypokalemia is a common side effect of furosemide and may enhance digoxin toxicity.

Question 4 of 5

A client receiving Parnate (tranylcypromine) is admitted in a hypertensive crisis. Which food is most likely to produce a hypertensive crisis when taken with the medication?

Correct Answer: D

Rationale: MAOIs like tranylcypromine interact with tyramine-rich foods like aged cheddar cheese, causing hypertensive crisis. Processed, cottage, and cream cheeses have lower tyramine content.

Question 5 of 5

A physician's order reads: Administer KCl 10% oral solution 1.5 mL. The KCl bottle reads 20 mEq/15 mL. What dosage should the nurse administer to the infant?

Correct Answer: C

Rationale: 1.33 mEq = 1 mL, then 1.5 mL X = 1.99, or 2 mEq.

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