A nurse is administering IV mannitol to a client diagnosed with cerebral edema. Which of the following actions should the nurse perform prior to the administration of mannitol?

Check for crystallization in the mannitol solution before administration.

Administer mannitol rapidly over 10 minutes.

Ensure systolic blood pressure is below 100mmm Hg

Administer mannitol with food to improve absorption.

Answer and Explanation

The Correct Answer is A

Cerebral edema involves increased intracranial pressure due to fluid accumulation within brain tissues, which can lead to decreased cerebral perfusion and neurological deterioration. Mannitol is an osmotic diuretic used to reduce intracranial pressure by drawing fluid from brain tissue into the intravascular space for renal excretion. Because mannitol can crystallize at room temperature, proper preparation and safety checks are essential before IV administration to prevent harm and ensure therapeutic effectiveness.

Rationale:
A. Checking for crystallization in the mannitol solution is essential before administration because mannitol can form crystals when stored at low temperatures. Infusing crystallized solution can cause catheter occlusion or embolization. If crystals are present, the solution should be warmed or filtered before use to ensure safe administration.

B. Administering mannitol rapidly over 10 minutes is unsafe unless specifically prescribed, as rapid infusion can cause sudden fluid shifts and cardiovascular overload. Mannitol should be administered at the prescribed controlled rate to prevent complications such as pulmonary edema, hypotension, or electrolyte imbalance. Proper infusion timing is critical to avoid adverse hemodynamic effects.

C. Ensuring systolic blood pressure is below 100 mm Hg is not a required pre-administration parameter for mannitol. While blood pressure monitoring is important due to the risk of fluid shifts and osmotic diuresis, the drug is not contraindicated based solely on systolic pressure thresholds. The focus is on intracranial pressure reduction rather than strict blood pressure limits.

D. Administering mannitol with food to improve absorption is incorrect because mannitol is given intravenously, not orally. Food intake has no effect on its absorption or pharmacologic action. Its therapeutic effect depends entirely on controlled IV infusion and its osmotic movement across the blood-brain barrier.

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Correct Answer is D

Explanation

Angina pectoris occurs when myocardial oxygen demand exceeds oxygen supply, often triggered by physical exertion or stress. This imbalance leads to transient chest pain due to myocardial ischemia without irreversible myocardial damage. Acute management focuses on rapidly relieving ischemia by improving coronary blood flow and reducing cardiac workload. Immediate symptom relief is essential to prevent progression to myocardial infarction.

Rationale:
A. Metoprolol is a beta-blocker that decreases heart rate and myocardial oxygen demand, making it useful for long-term angina management and prevention of episodes. However, it is not the first-line medication for immediate relief of acute anginal pain because it does not act quickly enough to terminate ongoing ischemia. It is more appropriate for chronic control rather than acute symptom resolution.

B. Aspirin is important in acute coronary syndromes because it inhibits platelet aggregation and helps prevent clot formation. However, it does not provide immediate relief of chest pain because it does not directly improve coronary blood flow or reduce myocardial oxygen demand. It is an adjunct therapy rather than the primary agent for acute angina relief.

C. Clopidogrel is an antiplatelet agent used to prevent further thrombus formation in clients with coronary artery disease. It works by inhibiting ADP-induced platelet aggregation but has no immediate effect on chest pain or myocardial oxygen supply-demand balance. It is used for secondary prevention rather than acute symptom management.

D. Nitroglycerin is the priority treatment for acute angina because it rapidly dilates coronary arteries and reduces myocardial oxygen demand. It works by relaxing vascular smooth muscle, improving blood flow to ischemic myocardium, and decreasing preload. This leads to quick relief of chest pain and is the first-line medication for acute anginal episodes.

A. Provide education on the routine screenings by age B. Providing education on tobacco cessation C. Encouraging the client to maintain a healthy weight and stay physically active D. Suggesting that skin protection measures, such as the use of sunscreen E. Teach the client on how and when to perform breast self-examination F. Encourage hepatitis B and HPV vaccinations

Correct Answer is ["B","C","D","F"]

Explanation

Primary cancer prevention focuses on reducing exposure to risk factors and strengthening protective behaviors before cancer develops. It targets lifestyle modification, vaccination against oncogenic viruses, and avoidance of known carcinogens. These strategies aim to decrease cellular damage and mutation risk at the earliest stage of disease development. Nurses play a key role in educating clients on evidence-based preventive measures that reduce overall cancer incidence.

Rationale:
A. Providing education on routine screenings by age is not primary prevention because screening is a form of secondary prevention. Screening aims to detect cancer early, before symptoms develop, rather than preventing its occurrence. Examples include mammograms, colonoscopies, and Pap smears, which identify disease at an early stage.

B. Providing education on tobacco cessation is a primary prevention strategy because tobacco use is a major modifiable risk factor for multiple cancers, including lung, oral, and bladder cancer. Eliminating exposure to carcinogens in tobacco significantly reduces cellular damage and mutation risk. Smoking cessation also improves overall respiratory and cardiovascular health.

C. Encouraging the client to maintain a healthy weight and stay physically active is a primary prevention measure. Obesity and sedentary lifestyle are associated with increased risk for cancers such as breast, colorectal, and endometrial cancer. Regular physical activity and weight control help regulate hormones and reduce chronic inflammation linked to cancer development.

D. Suggesting skin protection measures such as sunscreen use is a primary prevention intervention. Ultraviolet (UV) radiation exposure is a major risk factor for skin cancers, including melanoma and basal cell carcinoma. Protective behaviors such as sunscreen application, protective clothing, and limiting sun exposure reduce DNA damage in skin cells.

E. Teaching the client how and when to perform breast self-examination is not considered primary prevention but rather secondary prevention. Self-examination is intended for early detection of existing abnormalities, not prevention of cancer development. It helps identify lumps or changes that may require further diagnostic evaluation.

F. Encouraging hepatitis B and HPV vaccinations is a primary prevention strategy because these infections are linked to cancers such as hepatocellular carcinoma and cervical cancer. Vaccination prevents viral infections that can lead to long-term cellular changes and malignant transformation. Immunization significantly reduces the incidence of virus-associated cancers.

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A nurse is administering IV mannitol to a client diagnosed with cerebral edema. Which of the following actions should the nurse perform prior to the administration of mannitol?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The nurse is assessing a client presenting with chest pain and determines that the client's symptoms correlate with angina-type pain, which was provoked by exercise. Which of the following treatments would be prioritized for this client's acute condition?

Correct Answer is D

Explanation

A nurse is caring for a client in an outpatient clinic who is undergoing routine screenings and lifestyle counseling. The nurse emphasized the need for annual check-ups to monitor health status. What other primary cancer prevention strategies should the nurse include? Select all that apply.

Correct Answer is ["B","C","D","F"]

Explanation

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