111 Mss Pages
PN Comprehensive Review CD Questions 401-500
401. A client with tuberculosis is being started on antituberculosis therapy with isoniazid(INH). The nurse reviews the client’s health care record to be sure that which of thefollowing baseline studies have been completed before giving the client the first dose?1. Coagulation times2. Electrolytes3. Serum creatinine4. Liver enzymesAnswer: 4Rationale: Isoniazid therapy can cause an elevation of hepatic enzymes and hepatitis.Therefore liver enzymes are monitored when therapy is initiated and during the first 3months of therapy. They may be monitored longer in the client who is over age 50 or abuses alcohol. Options 1, 2, and 3 are not specifically related to the administration of this medication.Test-Taking Strategy: Focus on the name of the medication. Recalling that thismedication can be toxic to the liver will direct you to the correct option. Review thismedication if you had difficulty with this question.Level of Cognitive Ability: AnalysisClient Needs: Physiological IntegrityIntegrated Process: Nursing Process/ImplementationContent Area: Adult Health/RespiratoryReference: Lehne, R. (2004).
Pharmacology for nursing care
(5th ed.). Philadelphia:W.B. Saunders, p. 944.402. A nurse is monitoring the respiratory status of the client who has suffered afractured rib. The nurse monitors the client and understands that which manifestation isunrelated to the rib fracture?1. Pain, especially with inspiration2. Slow, deep respirations3. Splinting or guarding the chest4. Bruising over the fracture areaAnswer: 2Rationale: Rib fractures are a common injury, especially in the older client, and resultfrom a blunt injury or a fall. Typical signs and symptoms include pain and tendernessthat is localized at the fracture site and is exacerbated by inspiration and palpation,shallow respirations, splinting or guarding the chest protectively to minimize chestmovement, and possible bruising at the fracture site.Test-Taking Strategy: Use the process of elimination and note the key word
.This word indicates a false response question, and you need to select the incorrectmanifestation. Knowing that fractured ribs can cause pain and bruising helps you toeliminate options 1 and 4 first. To select between options 2 and 3, recalling that paincauses shallow, guarded respirations helps you to choose option 2 as the unrelatedfinding. Review the clinical manifestations in rib fractures if you had difficulty with this