What drug should the nurse question a 23-year-old client with sinus tachycardia about using?

Correct Answer: C

Rationale: The correct answer is C: Cocaine. Sinus tachycardia is a condition characterized by a fast heart rate originating from the sinus node. Cocaine is a stimulant drug that can significantly increase heart rate, exacerbating sinus tachycardia. The nurse should question the client about cocaine use to address the potential cause of the elevated heart rate. Other choices are incorrect: A: Barbiturates are central nervous system depressants and can slow heart rate, not cause sinus tachycardia. B: Opioids are also central nervous system depressants and do not typically cause sinus tachycardia. D: Benzodiazepines are sedatives and do not commonly lead to sinus tachycardia.

Correct Answer: B

Rationale: Correct Answer: B - Avoid green leafy vegetables. Rationale: 1. Coumadin is a blood thinner that works by affecting vitamin K levels. 2. Green leafy vegetables are high in vitamin K, which can interfere with Coumadin's effectiveness. 3. Instructing the client to avoid green leafy vegetables helps maintain a consistent level of vitamin K in the diet, thus ensuring the proper effect of Coumadin. Summary of other choices: A: Having a PTT done monthly is not necessary for a client discharged with Coumadin. C: Drinking more liquids is not directly related to Coumadin therapy. D: Avoiding crowds is unrelated to Coumadin therapy and does not impact its effectiveness.

Correct Answer: B

Rationale: The correct answer is B: 15 seconds. Suction attempts should generally be limited to 15 seconds to prevent hypoxia and tissue damage. Prolonged suctioning can lead to decreased oxygenation and potential trauma to the airway. Choice A (5 seconds) may not be sufficient for effective suctioning. Choice C (30 seconds) and D (1 minute) exceed the recommended time limit and increase the risk of complications. Therefore, choice B is the most appropriate duration for a suction attempt.

Correct Answer: D

Rationale: The correct first action is D: Consult with the primary health care provider (PHCP) regarding initiation of oxygen therapy. This is because the client is showing signs of a potential transfusion reaction, likely a pulmonary embolism. The client's rapid heart rate, bounding pulse, and crackling sound at the base suggest a possible pulmonary issue. Oxygen therapy is crucial to improve oxygenation and stabilize the client's condition. Consulting with the PHCP ensures timely intervention and appropriate management. A: Maintaining bed rest with legs elevated would not address the potential respiratory distress the client is experiencing. B: Placing the client in high-Fowler's position may help improve oxygenation, but consulting the PHCP for oxygen therapy is the priority. C: Increasing the rate of IV fluids is not the priority when the client is showing signs of a potential serious complication like a pulmonary embolism.

Correct Answer: D

Rationale: The correct answer is D. When administering a subcutaneous injection to an obese patient, it is best for Nurse Andrae to spread or pinch the skin at the injection site and inject the needle at a 45-90 degree angle. This allows for proper medication absorption due to the thicker layer of subcutaneous fat in obese patients. Pinching the skin helps ensure the medication is injected into the subcutaneous tissue rather than the muscle. Options A and B are not ideal for obese patients as they may not penetrate the thicker layer of fat effectively. Option C, the Z track method, is typically used for intramuscular injections and is not necessary for subcutaneous injections in obese patients.