A nurse is collecting data from a client who is taking aspirin.
Which of the following findings should the nurse report to the provider?
Headache.
Rhinitis.
Hct 43%.
BP 120/70 mm Hg.
The Correct Answer is B
Choice A rationale:
While headache can be a side effect of aspirin, it’s usually not severe enough to warrant reporting to the provider unless it’s persistent or severe.
Choice B rationale:
Rhinitis, or inflammation of the mucous membrane of the nose, can be an allergic reaction to aspirin and should be reported to the provider.
Choice C rationale:
Hematocrit (Hct) level of 43% is within the normal range for both men (38.8–50.0 %) and women (34.9–44.5 %), so this finding would not need to be reported.
Choice D rationale:
A blood pressure reading of 120/70 mm Hg is within the normal range and would not need to be reported.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice Arationale:
Aspiration (pulling back on the syringe before injection) is not recommended when administering enoxaparin. This could cause bruising.
Choice Brationale:
You should not massage the site following the injection as this could cause bruising.
Choice Crationale:
With enoxaparin and other low molecular weight heparins, you do not need to expel the air bubble before injecting the medication. The air bubble ensures that all the medication is delivered.
Choice D rationale:
Enoxaparin should be injected into abdominal tissue. This helps ensure proper absorption and reduces the risk of bruising.
Correct Answer is D
Explanation
Choice A rationale:
A Positive Chvostek’s sign is a clinical finding associated with hypocalcemia, or low levels of calcium in the blood. It’s not directly related to glyburide usage or symptoms of anxiety and profuse sweating.
Choice B rationale:
Pitting pedal edema occurs when excess fluid builds up in the body, causing swelling. It’s not directly related to glyburide usage or symptoms of anxiety and profuse sweating.
Choice C rationale:
Decreased deep-tendon reflexes or hyporeflexia happens when your skeletal muscles have a decreased or absent reflex response. It’s not directly related to glyburide usage or symptoms of anxiety and profuse sweating.
Choice D rationale:
Decreased blood glucose level or hypoglycemia occurs when your blood sugar (glucose) level falls too low. Glyburide is an oral diabetes medicine that helps control blood sugar levels. Anxiety and profuse sweating are symptoms of low blood sugar.
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