A patient who is taking clopidogrel (Plavix) and aspirin is preparing for orthopedic surgery. The nurse will consult with the surgeon and provide which instruction to the patient?

Correct Answer: A

Rationale: The correct instruction to the patient who is taking clopidogrel (Plavix) and aspirin and is preparing for orthopedic surgery is to continue taking aspirin and stop taking clopidogrel 2 weeks prior to surgery. Clopidogrel is an antiplatelet medication that irreversibly inhibits platelet activation and aggregation, which can increase the risk of bleeding during surgery. However, aspirin has a different mechanism of action and does not have as profound an effect on platelet function as clopidogrel. By continuing aspirin and stopping clopidogrel, the patient can still receive some antiplatelet protection while minimizing the bleeding risk associated with clopidogrel. It is important for the nurse to consult with the surgeon to ensure the best course of action for the patient's specific situation.

Correct Answer: A

Rationale: In this scenario, the correct answer is A) 60 mL. When determining delayed gastric emptying, a residual of more than 60 mL indicates that the stomach is not effectively emptying its contents. This can lead to complications such as aspiration, discomfort, and poor absorption of enteral feedings. Option B) 125 mL is incorrect because waiting for a residual of this amount could lead to delayed intervention for patients at risk. Option C) 150 mL is also too high a threshold and could result in increased risks for patients. Finally, option D) 75 mL is closer but still higher than the recommended threshold of 60 mL. In an educational context, it is crucial for nurses to understand the significance of gastric residuals in patients receiving enteral feedings. Teaching this concept helps nurses monitor patient tolerance to feedings, prevent complications, and intervene promptly when necessary. Understanding the appropriate thresholds for gastric residuals enhances patient safety and promotes optimal outcomes in enteral feeding management.

Correct Answer: C

Rationale: Anticipatory nausea and vomiting occur before chemotherapy administration and are a conditioned response to previous chemotherapy experiences. This psychological response is triggered by cues such as the sight or smell of the treatment environment. It is distinct from acute or delayed nausea and vomiting, which occur during or after chemotherapy. Anticipatory nausea and vomiting can be challenging to manage and often require behavioral interventions or anti-anxiety medications.

Correct Answer: A

Rationale: Magnesium sulfate toxicity can cause respiratory depression, which is indicated by a respiratory rate of 10 breaths per minute or less. This is a life-threatening complication requiring immediate intervention. Deep tendon reflexes are typically absent in severe toxicity, not present. A urine output of 25 ml/hr may indicate renal impairment but is not specific to magnesium toxicity. A serum magnesium level of 7 mEq/L is elevated but does not alone confirm toxicity without clinical symptoms. Therefore, respiratory depression is the key indicator.

Correct Answer: D

Rationale: Acute asthma and pneumonia in pregnancy require urgent care. IV crystalloids rehydrate, safe and necessary. High FiO2 (40%) supports oxygenation in asthma/pneumonia, appropriate. Nebulized salbutamol, a beta-agonist, relieves bronchospasm, standard and safe. IV hydrocortisone reduces inflammation, suitable. IV gentamicin, an aminoglycoside, treats pneumonia but is inappropriate due to cephalosporin cross-reactivity risk (angioedema history) and fetal ototoxicity concerns, making it unsafe here. Alternative antibiotics (e.g., macrolides) are preferred, prioritizing maternal and fetal safety.