You are an RN working in a busy Emergency Department and have just received a new patient who smells like alcohol, has bloodshot eyes, and reports a severe headache. The patient states that he hasn't had a real meal in a long time, and drinks several large bottles of alcohol daily. What do you anticipate administering to this patient based upon his history?

Timolol eyedrops

Acetaminophen

Aspirin

Banana bag

Answer and Explanation

The Correct Answer is D

A.   Timolol is a beta-blocker used primarily to treat glaucoma by reducing intraocular pressure. It would not address the issues presented by this patient, who is likely dealing with alcohol-related complications.
B.   Acetaminophen is used to relieve pain and reduce fever. While the patient reports a severe headache, administering acetaminophen may not be advisable due to potential liver damage from alcohol use, especially if the patient has not eaten properly. Chronic alcohol use can also increase the risk of hepatotoxicity with acetaminophen.
C.   Aspirin is another pain reliever that could potentially be used for headaches. However, like acetaminophen, it carries risks for patients with alcohol use, particularly gastrointestinal bleeding. Additionally, aspirin should be used cautiously in cases of possible liver impairment.
D.   A "banana bag" is a term for an intravenous solution often used in patients with alcohol use disorder to provide hydration and essential vitamins, especially thiamine, which can prevent Wernicke's encephalopathy. It typically contains normal saline or dextrose, electrolytes, and vitamins (including B1, B6, and B12).

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Correct Answer is B

Explanation

A. Diabetes Insipidus is primarily related to issues with the production of vasopressin (ADH) or the body's response to it, which is not directly caused by CKD. CKD may lead to fluid retention and imbalances, but it does not typically cause recurrent bouts of diabetes insipidus.
B. In CKD, the kidneys lose their ability to produce erythropoietin, a hormone that stimulates red blood cell production in the bone marrow. Patients often require erythropoiesis-stimulating agents (ESAs) like erythropoietin injections to manage anemia associated with CKD.
C. CKD patients are often hyperkalemic (high potassium levels) rather than hypokalemic. As kidney function declines, the kidneys struggle to excrete potassium, leading to elevated levels, which can cause serious complications.
D. CKD patients often experience hypocalcemia (low calcium levels) due to several factors, including decreased activation of vitamin D and imbalances in phosphate levels. While some patients may experience transient hypercalcemia due to treatments or dietary factors, chronic hypercalcemia is not typical in CKD.

A. Use paper tape on fragile skin B. Provide mouthwash with alcohol for oral care C. Avoid aspirin D. Provide a soft bristle toothbrush or oral sponge E. Teach to use an electric shaver instead of a razor

Correct Answer is ["A","C","D","E"]

Explanation

A. Paper tape is gentler on fragile skin compared to standard adhesive tape. It reduces the risk of skin tears and bleeding, making it a safer option for patients with thrombocytopenia.
B. This option is not advisable. Mouthwash containing alcohol can irritate and dry out the mucous membranes in the mouth, potentially leading to ulcers or bleeding. Instead, an alcohol-free mouthwash should be used for oral care.
C. Aspirin is an antiplatelet agent that can increase the risk of bleeding. Patients on bleeding precautions should avoid aspirin and other non-steroidal anti-inflammatory drugs (NSAIDs) to minimize the risk of excessive bleeding.
D. A soft-bristle toothbrush or oral sponge is recommended for oral care to minimize trauma to the gums and mucous membranes. This helps reduce the risk of bleeding in patients with low platelet counts.
E. Using an electric shaver is safer than a traditional razor, as it reduces the risk of cuts and nicks that can lead to bleeding. This precaution is particularly important for patients with thrombocytopenia.

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Naxlex Comprehensive Predictor Exams

The nurse preceptor is teaching the newly graduated nurse about the care and treatment of patients with Chronic Kidney Disease (CKD) who are on dialysis treatment. Which of the following statements is TRUE?

Correct Answer is B

Explanation

Patients receiving chemotherapy are at risk for thrombocytopenia related to chemotherapy or disease processes. Which actions. are needed for patients who must be placed on bleeding precautions? (Select all that apply)

Correct Answer is ["A","C","D","E"]

Explanation

Which of the following are common signs or symptoms of GI bleeding? (Select all that apply)

A nurse is assessing a client who has a new diagnosis of SLE (Lupus). Which of the following findings should the nurse expect?

A nurse is caring for a client who has SLE and is experiencing an episode of Raynaud's phenomenon. Which of the following findings should the nurse anticipate?

A nurse is caring for a patient who, upon awakening, was disoriented to person, place, and time. The client reports chills and chest pain that is worse upon inspiration. Which of the following actions is the nursing PRIORITY?

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Which of the following are common signs and symptoms that can be present when your patient has Rheumatoid Arthritis? (Select all that apply)

A transfusion of packed red blood cells (PRBCs) has been infusing for 5 minutes when the patient becomes flushes and tachypneic and says, "I'm having chills. Please get me a blanket." Which action should the nurse take first?