PassPoint Practice Questions

The client has been admitted to the hospital with generalized seizures and the healthcare provider ordered pentobarbital sodium. What discharge teaching will the nurse include about pentobarbital sodium?

"Alcohol can cause drug toxicity with pentobarbital sodium."

A client is asking for information about using an intrauterine device (IUD). Which question when asked by the nurse would provide pertinent information on whether or not a client is a candidate for an IUD?

"Are you in a monogamous relationship?"

The healthcare provider has ordered chlorpromazine for a client diagnosed with schizophrenia. What should the nurse include in the client's teaching concerning the administration of chlorpromazine?

"Chlorpromazine can cause involuntary movements of the face and jaw."

The parent of several young children calls the nurse when a school-age child comes down with chickenpox. The nurse provides instruction on communicability and home management of this disease. Which response by the parent indicates effective teaching?

"I should have my child soak in oatmeal baths twice daily."

The nurse is preparing a client for a cardiac catheterization. Which client statement would the nurse need to report to the healthcare provider immediately?

"I took my metformin this morning."

A client is scheduled for a creatinine clearance test. The client needs further instruction about preparing for the test after making which statement?

"I will be sure to fast from midnight until the test begins at 8:00 am the following day."

Which statement indicates that the client with hepatitis B has understood the nurse's discharge teaching?

"I won't drink alcohol for at least 1 year."

A client is prescribed lithium. Which statement by this client most indicates a need for more teaching?

"I've learned to take my lithium even when I have the stomach flu."

A nurse is explaining the use of ceftriaxone and doxycycline to a client with gonorrhea. The client asks the nurse the reason for two antibiotics. What is the nurse's best response?

"Often people infected with gonorrhea are also infected with chlamydia, which requires a different antibiotic."

The nurse is working on a labor and delivery unit, and is precepting a new graduate nurse. The graduate asks the preceptor, "Is oxytocin used for pain in labor and delivery?" What is the best response by the preceptor? Select all that apply.

"Oxytocin is used to control postpartum bleeding." "Oxytocin is used to stimulate breast milk ejection." "Oxytocin is used for labor induction."

A client with type 1 diabetes mellitus must learn how to self-administer insulin. When teaching the client how to select and rotate insulin injection sites, the nurse should provide which instruction?

"Rotate injection sites within the same anatomic region."

The healthcare provider orders a new medication for a 5-year-old client. The nurse educator asks the student, "What is a medication dose affected by?" What is the best response by the student? Select all that apply.

"disease state" "weight"

The nurse is caring for a school-age child admitted with an exacerbation of Crohn's disease. The healthcare provider prescribes total parenteral nutrition (TPN) via peripheral intravenous line. The nurse identifies what concentration of dextrose in the TPN solution as most appropriate?

10% glucose

What is the maximum amount of medication (in milliliters) that can be administered into the deltoid muscle? Record your answer using a whole number.

2 mL

The nurse is taking a health history of a pediatric client that is taking half a teaspoon of cetirizine every day at home. The medication the parents bring to the office has a concentration of 1 mg/mL solution. How many mg is this client receiving per day? Round the answer to the nearest tenth place.

2.5 Half a teaspoon is 2.5 mL (5 mL = 1 teaspoon). If the solution is 1 mg/mL. then 2.5 mL = 2.5 mg.

While performing an assessment, the nurse notes the infant's jaundice has moved from the nipple line to the umbilicus in the past 24 hours. How does the nurse interpret this physical finding?

An increase in bilirubin level is probable.

The nurse is caring for a client who is 1 day post total hip replacement. The client has patient-controlled analgesia (PCA) but is reporting pain. Which action would be most important for the nurse to take in relation to the client's pain management?

Assess the client's pain to determine whether the PCA dosage is adequate.

A client at 35 weeks' gestation reports severe abdominal pain and passing clots. The client's vital signs are blood pressure 150/100 mm Hg, heart rate 95 beats/minute, respiratory rate 25 breaths/minute, and fetal heart tones 160 beats/minute. The admitting nurse must determine the cause of the bleeding and respond appropriately to this emergency. Which action should the nurse do first?

Assess the location and consistency of the uterus.

The nurse is developing a teaching plan for the client with aplastic anemia. Which instruction is most important to include in the plan?

Avoid exposure to others with acute infections.

A client diagnosed with leukemia is now experiencing neutropenia. Which assessment related to neutropenia is a priority for the nurse?

Breath sounds

The nurse is caring for an unconscious intubated client with normal intracranial pressure. What should the nurse include in the care plan?

Clean the mouth carefully, apply a thin coat of a lubricant, and move the endotracheal tube to the opposite side daily.

The nurse is assessing the urine of a client who has had an ileal conduit and notes that there is a moderate amount of mucus in the urine. What should the nurse do next?

Encourage a high fluid intake.

A child with type 1 diabetes mellitus reports feeling shaky. The child's skin is pale and sweaty. What is the nurse's priority intervention?

Have the child eat a glucose tablet.

Sulfamethoxazole/trimethoprim has been prescribed for a client who has a urinary tract infection. What should the nurse do when administering sulfonamides?

Instruct the client to drink at least eight glasses of water a day.

A client scheduled for hip replacement surgery wishes to receive their own blood for the upcoming surgery. What should the nurse do?

Notify the surgeon's office.

A nasogastric tube inserted during surgical correction of an infant's intussusception is no longer freely removing gastric secretions. What should the nurse do next?

Verify the tube placement.

The cervix of a primigravid client in active labor who received epidural anesthesia 4 hours ago is now completely dilated, and the client is ready to begin pushing. What is most important for the nurse to assess before the client begins to push?

bladder status

The nurse is caring for a 1-month-old infant who fell from the changing table during a diaper change. Which signs and symptoms of increased intracranial pressure (ICP) is the nurse likely to assess in a 1-month-old infant? SATA

bulging fontanels high-pitched cry irritability

Which is a priority nursing action for a child with croup?

continually assessing respiratory status

The nurse observes the client instill eye drops. The client says, "I just try to hit the middle of my eyeball so the drops do not run out of my eye." What should the nurse tell the client about this method of instilling eye drops? This method may cause:

corneal injury.

The nurse cares for a client who is intoxicated on phencyclidine (PCP). Which liquid should the nurse administer to hasten excretion of the chemical?

cranberry juice

A client is receiving lithium carbonate for a bipolar disorder. The nurse is aware that early signs of lithium toxicity include:

diarrhea

The nurse is administering a cephalosporin to a client. The nurse should monitor the client for which finding?

drug-induced hemolytic anemia

The client presents to the clinic with severe anemia, and is a Jehovah's Witness with religious beliefs that prohibit the administration of blood products. Which concurrent medications does the nurse teach the client about when receiving blood products? Select all that apply.

epoetin alfa ferrous sulfate

The nurse cares for a multigravid client in active labor with a fetus in a frank breech presentation. The nurse should notify the primary care provider if the nurse makes which observation?

fetal bradycardia at any time during the labor process

A 30-week gestation mother is admitted to the labor and delivery unit with contractions every 10 minutes and intact membranes. The nurse is to administer terbutaline to help stop the contractions. What priority assessment of the client will the nurse perform when administering this drug?

heart rate

The nurse is caring for a client who has had a postpartum hemorrhage. The healthcare provider has prescribed methylergonovine maleate. What would be a contraindication for a client who has been prescribed this medication? Select all that apply.

history of high blood pressure known drug sensitivity to methylergonovine maleate cardiac disease

The nurse is teaching the client how to use a metered-dose inhaler (MDI) to administer a corticosteroid. Which observation(s) indicates that the client is using the MDI correctly? Select all that apply. The client:

holds the inhaler upright. rinses the mouth with water following administration.

The nurse is reviewing the medical record of a multigravid client at 39 weeks' gestation with suspected HELLP syndrome. The nurse should notify the health care provider about which test result?

lactate dehydrogenase (LDH) > 200 U/L (3.34 µkat/L)

The nurse assesses a client with possible alcohol poisoning. The nurse should investigate the client's use of which substance while drinking alcohol?

marijuana

During morning care, a nurse notes that a client who's had a spinal cord injury has experienced a change in level of consciousness and isn't answering questions appropriately. The nurse checks the client's vital signs and measures the client's blood pressure at 180/110 mm Hg and heart rate at 125 beats/minute. The nurse determines that the client may be experiencing dysreflexia. What other assessments should the nurse make? SATA

most recent bowel movement urine output pain level

A client involved in a motor vehicle accident arrives at the emergency department unconscious and severely hypotensive. The nurse suspects the client has several fractures in the pelvis and legs. Which parenteral fluid is the best choice for the client's current condition?

normal saline solution

The client is prescribed warfarin sodium for deep vein thrombosis (DVT). Which other medication does the nurse anticipate needing on the nursing unit?

phytonadione

The nurse interviews a client with systemic lupus erythematosus (SLE) who reports to the emergency department with severe back pain after a minor fall. What aspect of the client's medical history is most relevant to the potential cause of this injury?

prescription for prednisone

A nurse is caring for a school-age client who is in the second percentile of height and weight for age as a result of an endocrine disorder. Which pharmacological intervention should the nurse anticipate?

replacement with biosynthetic growth hormone

An older adult client has been treated for stage 4 left-sided heart failure for several days. New laboratory results indicate serum sodium of 130 mEq/L (130 mmol/L), TCO2 36 mEq/L (36 mmol/L), and potassium 3.4 mEq/L (3.4 mmol/L). The nurse suspects these results are related to one of the client's medications prescribed to treat heart failure and its complications. The nurse prioritizes assessing what systems prior to contacting the healthcare provider about reassessing the medication?

respiratory status and fluid balance

A client with a positive Mantoux test result is taking isoniazid (INH) and rifampin (RIF) for treatment of tuberculosis. In the nursing assessment, the nurse should assess specifically for which finding during the clinic visit?

sclera

While admitting a client to the alcohol treatment program, the nurse asks the client how long they have been drinking, how much they have been drinking, and when they had their last drink. The client replies that they have been drinking about a liter of vodka a day for the past week and their last drink was about an hour ago. This information helps the nurse to determine which factor?

severity of withdrawal symptoms

A nurse is teaching a client how to administer oxytocin for lactation stimulation. The teaching has been successful if the client administers the drug

sitting with her head vertical.

A parent brings in a school-age child to the clinic for treatment. The child is small in stature, but body parts are in proportion. Which pharmacological treatments does the nurse anticipate instructing the parent about?

somatrem

A nurse is analyzing a client's intake and output. The client has a temperature of 102°F (38.9°C) and is receiving 2400 mL of intravenous (IV) fluids per 24 hours because the client is to have nothing by mouth. What information should the nurse obtain before taking action?

the amount of insensible fluid loss through the lungs and skin

After the nurse teaches the client about the use of skeletal traction, which statement made by the client about the purpose of the traction indicates the need for additional teaching?

to pull weight with a boot

A nurse is caring for a client following a hypophysectomy. Included in the postoperative orders is vasopressin intramuscularly. Which rationale is most correct for the administration of this medication?

to replace antidiuretic hormone (ADH)

A client is taking a progestin-only oral contraceptive, or minipill. When teaching the client about this medication, a nurse should include information on signs and symptoms of

tubal or ectopic pregnancy.

A neonate born at 30 weeks' gestation and weighing 2000 g is admitted to the neonatal intensive care unit. What nursing measure will decrease insensible water loss in a neonate?

use of humidity in the incubator

A client with heart failure is given a prescription for torsemide. Two days after the drug therapy is started, which sign indicates the drug is having the intended outcome? The client:

weighs 7 lb (3 kg) less than the client did 2 days ago.

Which laboratory test result should the nurse review in a child with nephrotic syndrome who is receiving cyclophosphamide?

white blood cell (WBC) count

A client is ordered hydralazine for blood pressure management. The nurse is teaching the client about hydralazine therapy. The nurse should instruct the client to take hydralazine

with food.

The nurse is teaching a client with Cushing disease about taking oral glucocorticoids. What information should the nurse give to the client about taking the medication?

with meals or with an antacid

A teaches the client about the prescribed medication sertraline. Which comment indicates that a client understands the nurse's teaching?

"This medicine can cause delayed ejaculation."

A female client with bipolar disorder who has been taking risperidone 2 mg orally twice a day informs the nurse that they are 8 weeks' pregnant. The client asks if they should continue the medication. What is the nurse's best response?

"The benefits of you staying on this medication that has controlled your symptoms outweighs the risk to the fetus."

A client returns to the room from the postanesthesia care unit after undergoing a right hemicolectomy. The health care provider orders 1 L of dextrose 5% in half-normal saline solution to infuse at 125 ml/hour. The drop factor of the available intravenous tubing is 15 gtt/ml. What is the drip rate in drops per minute? Round your answer to the nearest whole number. (For example: 62)

31 The flow rate is 125 ml/hour or 125 ml/60 minutes. Use this equation to determine the drip rate:125 ml/60 minutes x 15 gtt/1 ml = 31.25 gtt/minute (round down to 31 gtt/minute).

A physician orders cefoxitin, 1 g in 100 ml of 5% dextrose in water, to be administered I.V. A nurse determines that the recommended infusion time is 15 to 30 minutes. The available infusion set has a calibration of 10 drops/ml. To infuse cefoxitin over 30 minutes, which drip rate should the nurse use?

33 drops/minute

A client receiving intravenous heparin has developed hematuria and petechiae. What is the nurse's best action?

Administer protamine sulfate.

A laboring client has an epidural anesthesia. Which of the following would be the priority interventions related to the maintenance of epidural anesthesia? Select all that apply.

Assess blood pressure every 30 minutes, and every 5 minutes with each bolus. Assess for prolonged second stage of labor. Use a hip wedge if the client is positioned supine.

The nurse is caring for a client who is 30 weeks pregnant and in preterm labor who has been prescribed a magnesium sulfate infusion. Which will the nurse include in the client's plan of care? SATA

Assess deep tendon reflexes (DTRs) every 4 hours. Monitor respiratory rate hourly and as needed. Ensure that calcium gluconate is on hand.

When developing a plan of care that includes interventions aimed at preventing complications of a low platelet count in a child with leukemia, which intervention is most appropriate?

Consult with a health care provider about the use of a stool softener.

What desired effect can the nurse expect after administering an antihistamine to a pediatric client with a disorder of the skin? Select all that apply.

Decreased itching Less skin irritation

A nurse is caring for a client who has been immobilized in Buck's traction for 3 weeks. Which actions by the nurse is most important in preventing a metabolic complication related to the immobilization?

Increase fluid intake and monitor urine output.

The nurse is reviewing prescriptions for a client newly admitted to the intensive care unit for diabetic ketoacidosis. Which medication prescription should the nurse question?

Insulin glargine 10 units IV once

The toddler with nephrotic syndrome responds to treatment and is ready to go home. When helping the family plan for home care, the nurse should include which instruction in the teaching?

Keep the child away from others with an infection.

A client is in isolation after receiving an internal radioactive implant to treat cancer. Two hours later, the nurse discovers the implant in the bed linens. What should the nurse do first?

Leave the room and notify the radiation therapy department immediately.

What is an appropriate nursing action to detect early signs of metabolic complications in a client receiving total parental nutrition (TPN)?

Monitor urine output.

A client's catheter is removed 4 days after transurethral resection of the prostate (TURP). The client is experiencing urinary dribbling. What should the nurse do?

Teach the client Kegel exercises.

What information should a nurse include when teaching post-circumcision care to the parents of a neonate prior to discharge from the hospital? Select all that apply.

The infant must void before being discharged. Petroleum jelly should be applied to the glans with each diaper change. The circumcision will require care for 2 to 4 days after discharge.

What is the best reason for assessing a neonate weighing 1500 g (1.5 kg) at 32 weeks' gestation for retinopathy of prematurity (ROP)?

The neonate is at risk because of multiple factors.

A client with schizophrenia who is receiving antipsychotic medication reports feeling nervous. The client paces, fidgets, and can't seem to stay still. Which disorder is the most likely cause?

akathisia

A nurse is assessing a client who is 6 weeks pregnant. Which findings best support a suspicion of ectopic pregnancy?

amenorrhea and adnexal fullness and tenderness

A nurse working in the emergency department is admitting a client with vomiting. What diagnosis would the nurse expect based on the progress note?

anaphylaxis reaction

A nurse is conducting a physical examination on a neonate. Which pulse point should the nurse check if a possible coarctation of the aorta is suspected?

femoral

A 70-year-old client with a diagnosis of left-sided stroke is admitted to the facility. To prevent the development of disuse osteoporosis, which objective is most appropriate?

promoting weight-bearing exercises

The nurse is preparing a client's preoperative medication. The prescription reads atropine 0.6 mg and meperidine hydrochloride 50 mg IM. The dosage of available atropine is 0.8 mg/mL, and the dosage of available meperidine is 100 mg/mL. What will be the total volume of medication the nurse will administer? Record your answer using two decimal places.

1.25 The atropine dosage is calculated as follows:0.6 mg/x mL = 0.8 mg/mL.x = 0.75 mL.The meperidine dosage is calculated as follows:50 mg/x mL = 100 mg/mL.x = 0.5 mL.The total volume to be administered is 1.25 mL.

The nurse is concerned about skin breakdown in a client with dehydration. What would the nurse calculate in milliliters as the balance between intake and output for an 8-hour shift? Record the answer as a whole number.

260 Total intake = 240 mL (8 ounces of water) plus 120 mL (4 ounces apple juice) plus an intravenous fluid bolus of 500 mL, which equals a total intake of 860. The client's output adds 500 + 100 to equal 600 mL. The bowel movement is not factored into the amount of output. Therefore, the net balance for this client of intake is 260 mL (860 - 600 mL).

The nurse is administering furosemide intravenously to a client with heart failure. How soon after administration should the nurse begin to see evidence of the drug's desired effect?

5 to 10 minutes

A client with pancreatic cancer has been prescribed a chemotherapeutic medication of 12 mg/kg intravenously for 4 days. If no signs of toxicity occur, the client is to receive 6 mg/kg of the medication on days 6, 8, 10, and 12. The client weighs 198 lb (90 kg). At the conclusion of day 12, how many total milligrams will the client have received? Record your answer as a whole number.

6480 Days 1-4: 12 mg/kg/day x 90 kg x 4 days = 4,320 mgDays 6, 8, 10, 12: 6 mg/kg/day x 90 kg x 4 days = 2,160 mgThen, add these amounts together:4,320 mg + 2,160 mg = 6,480 mg.

The nurse is administering an IV antibiotic to a client in the emergency department (ED). Within 15 minutes, the client reports itching, shortness of breath, and difficulty swallowing. Which interventions should the nurse implement? Select all that apply.

Administer epinephrine per order. Discontinue the medication. Apply oxygen.

A newly postpartum client is asking to go to the bathroom 45 minutes after birth. The client had an epidural for labor and birth and has an intravenous (IV) line infusing, and every 15 minutes assessments are in progress. What should the nurse do to provide the safest care for this client?

Assess the client's ability to stand and bear weight before ambulating to the bathroom.

A child diagnosed with type 1 diabetes has this order: Regular insulin 8 units to be administered subcutaneously before meals and at bedtime. Which are priority actions for the nurse to take to administer the medication safely? Select all that apply.

Check the blood glucose level. Verify the insulin order.

The nurse is caring for a client with a gastrostomy tube. Fifteen minutes after a bolus feeding the client experiences bloating, cramping, diarrhea, dizziness, diaphoresis, and weakness. What action should the nurse take?

Contact the healthcare provider to alter the enteral feeding prescription.

The provider has prescribed adenosine 6 mg IV once for the client with supraventricular tachycardia (SVT). How should the nurse administer this medication?

IV push as fast as possible

A client is admitted to the emergency department with anxiety and restlessness. The nurse observes the client exhibiting uncontrolled blinking, tremors, and facial stiffness. The client reports taking thioridazine, amitriptyline, and escitalopram at home. What is the priority action by the nurse?

Insert an intravenous catheter, and administer 1 mg benztropine intravenously as prescribed.

The nurse is assessing a client with a spinal cord injury for the development of deep vein thrombosis. Which is the most effective way to determine deep vein thrombosis in this client?

Measure leg girth.

A nurse is administering oxytocin to a client in labor. During oxytocin therapy, which intervention should the nurse include on the client's plan of care?

Monitor of intake and output.

A client is in the hospital with a peripherally inserted central catheter (PICC) in the right arm and is suspected of becoming septic. The nurse has to get a blood culture from this client. What is the best practice for this procedure?

Obtain a peripheral blood culture from the left arm.

The nurse is caring for a client who has a prescription for thigh high antiembolism stockings. The client's left thigh measures 3 in (7.5 cm) larger than the client's right thigh. What is the next action by the nurse?

Order two different sizes of stockings and use one from each package.

Because cervical effacement and dilation aren't progressing in a client in labor, the physician orders I.V. administration of oxytocin. Why must the nurse monitor the client's fluid intake and output closely during oxytocin administration?

Oxytocin causes water intoxication.

The nurse is discontinuing a peripheral venous access device. Place the steps in the order that the nurse should perform them. All options must be used.

Perform hand hygiene. Put on gloves. Remove tape and sterile dressing. Withdraw catheter. Apply pressure to area just above the insertion site. Apply an occlusive dressing to site.

A neonate was born to a mother diagnosed with hydramnios in utero. When the first feeding was given, the newborn began coughing, became cyanotic, and was having difficulty breathing. The nurse suspects esophageal atresia. Which is the priority nursing action for this neonate?

Placing the infant in an upright, 60° angle

A client with a subdural hematoma becomes restless and confused, with dilation of the ipsilateral pupil. What is the most important action by the nurse?

Preparing to administer hypertonic saline or mannitol per provider order

A client has been prescribed diuretic therapy for hypertension. It has been causing frequent urination at night and now the client is refusing to take the morning dose of furosemide. What would be the best response by the nurse?

Reinforce the reason for the medication. Respect the decision if the client still refuses the medication, and chart the refusal.

When developing a teaching plan for the parents of a child who is receiving digoxin, the nurse should provide which most important instruction?

Show the parent the correct prescribed dosage.

A client with heart failure has been receiving an I.V. infusion at 125 ml/hour. Now the client is short of breath and the nurse notes bilateral crackles, jugular vein distention, and tachycardia. What should the nurse do first?

Slow the I.V. infusion.

The client is scheduled to receive phenytoin through a nasogastric (NG) tube and has a tube-feeding supplement running continuously. The head of the bed is elevated to 30 degrees. Before administering the medication, the nurse should take which action?

Stop the tube feeding 1 hour before giving phenytoin, and hold the tube feeding for 1 hour after giving the medication.

The registered nurse (RN) is assisting the licensed practical nurse (LPN) in performing a purified protein derivative (PPD) test on a nursing home resident. Which statements about this test are correct? Select all that apply.

The PPD test is an intradermal test. The preferred injection site is the ventral surface of the forearm

A client is scheduled for a cardiac catheterization. The nurse should perform which preprocedural task(s)? SATA

Verify the client has stopped taking anticoagulants if instructed by the health care provider. Check for iodine sensitivity. Verify that written consent has been obtained. Withhold food and oral fluids before the procedure.

The nurse is developing a plan of care for a client with Crohn disease who is receiving total parenteral nutrition (TPN). Which intervention(s) should the nurse include? Select all that apply.

Weigh the client daily. Monitor the IV infusion rate hourly. Tape all IV tubing connections securely.

The nurse is discussing discharge instructions with a client with myasthenia gravis who is taking pyridostigmine. The nurse should tell the client to:

administer artificial tears.

The nurse-manager is teaching the staff about the medication reconciliation policy. The nurse teaches the staff that reconciliation is needed to ensure that clients are on the correct medications in which situation(s)? Select all that apply.

admission to the hospital transfer to the nursing home transfer of a client from surgery to the surgical unit admission to a home health agency from the hospital

Which hospitalized client is at risk for developing parotitis?

an 80-year-old client who has poor oral hygiene and is dehydrated

When prepping a client for a hemorrhoidectomy, which would be most important prior to the patient going to the operating room?

an enema

A nurse is caring for a client receiving the fentanyl transdermal system for pain management. When applying a new system, the nurse should:

apply the system immediately after removal from a package.

A client in labor is receiving magnesium sulfate to treat hypertension of pregnancy. How should this drug be administered?

as a loading dose of 4 g in dextrose 5% in water (D5W), followed by a continuous infusion of 1 to 2 g/hr

A client with a spinal cord injury has spinal shock. What should the nurse expect the client's bladder function to be at this time?

atonic

The nurse is caring for a client who is taking haloperidol. The client comes to the nurse's station and states that they feel frightened and their muscles hurt. The client is unable to turn their head to look at the nurse, the client's face is stiff, and they cannot move their tongue very well. Which prescribed as-needed (PRN) medication would be appropriate for the nurse to administer?

benztropine

A client with newly diagnosed type 1 diabetes is scheduled to receive regular insulin 10 units and NPH insulin 20 units every morning. When should the nurse schedule the administration of these medications?

both insulins 0.5 hours before breakfast

A physician orders cystoscopy and random biopsies of the bladder for a client who reports painless hematuria. Test results reveal carcinoma in situ in several bladder regions. To treat bladder cancer, the client will have a series of intravesical instillations of bacillus Calmette-Guérin (BCG), administered 1 week apart. When teaching the client about BCG, the nurse should mention that this drug commonly causes

hematuria

A nurse is assisting in monitoring a client who's receiving oxytocin to induce labor. Which maternal adverse reactions should the nurse should be alert to? Select all that apply.

hypertension fluid overload uterine tetany

A septic preterm neonate's intravenous (IV) line was removed due to infiltration. The nurse prioritizes restarting the IV to help which complication?

hypoglycemia

A male client with hair on the chest is prescribed dexamethasone cream for a rash over the midthoracic region. Which approach should the nurse use to apply this topical medication?

in long, even, outward, and downward strokes in the direction of hair growth

A client is prescribed chlordiazepoxide as needed to control the symptoms of alcohol withdrawal. Which symptoms may indicate the need for an additional dose of this medication? Select all that apply.

tachycardia elevated blood pressure and temperature tremors increasing anxiety