Nokea
The nurse in an ambulatory care center is reinforcing teaching to a client with a diagnosis of persistent depressive disorder (dysthymia) about the appropriate use of bupropion hydrochloride sustained release. What statement by the client indicates a need for further teaching?
- A. If I have a sudden change in my mood, I should call my physician immediately.
- B. If I have trouble swallowing the tablet, I can cut it in half.
- C. If I miss a dose, I should not double the next dose to catch up.
- D. It may take several weeks before I get better.
Correct Answer: B
Rationale: Bupropion sustained-release tablets must not be cut, as this disrupts the controlled-release mechanism, risking side effects. Other statements are correct: mood changes require reporting, missed doses shouldn't be doubled, and therapeutic effects take weeks.
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A client on the psychiatric unit does not get to the dining room to eat because she is continually washing her hands and doesn't finish until after lunch. What should be included in the nursing care plan?
- A. Give the client a choice between eating lunch and performing her ritual.
- B. Tell the client an hour before lunch so she can perform her ritual before lunch.
- C. Discuss the problem with the client and ask her why she washes her hands so long.
- D. Tell the client she cannot wash her hands at all if she is going to be late for lunch.
Correct Answer: B
Rationale: Advance notice allows the client with OCD to complete rituals before lunch, facilitating nutrition without confrontation. Choices, discussions, or bans are less effective.
A client with tuberculosis has an order for Rifadin (rifampin). What vitamin is usually given with rifampin?
- A. Thiamine
- B. Pyridoxine
- C. Folic acid
- D. Cyanocobalamin
Correct Answer: B
Rationale: Pyridoxine (vitamin B6) is given with rifampin to prevent peripheral neuropathy, a side effect. Other vitamins are not typically associated with rifampin therapy.
The nurse is collecting data from assigned clients. It would require follow-up if a
- A. 3-week-old client has an anterior fontanel that pulsates slightly and bulges when crying
- B. 4-week-old client has a posterior fontanel that is soft and flat to palpation
- C. 6-month-old client had a birth weight of 7 lb 3 oz (3300 g) and now weighs 12 lb (5400 g)
- D. 12-month-old client had a birth weight of 6 lb 4 oz (2800 g) and now weighs 19 lb 2 oz (8700 g)
Correct Answer: C
Rationale: A 6-month-old weighing only 12 lb (5400 g) from a birth weight of 7 lb 3 oz (3300 g) indicates failure to thrive, requiring follow-up. Other findings (fontanels, 12-month-old weight) are within normal ranges.
The nurse prepares to administer morning medications to assigned clients. Which prescription should the nurse clarify with the health care provider?
- A. Clopidogrel for client with history of stroke and platelet count of 154,000/mm² (154 x 10â¹/L)
- B. Losartan for client with hypertension who is 8 weeks pregnant
- C. Prednisone for client with herpes simplex lesions and Bell palsy
- D. Tiotropium for client with pneumonia and chronic obstructive pulmonary disease
Correct Answer: B
Rationale: Losartan is contraindicated in pregnancy due to fetal harm risks. Clopidogrel is safe with normal platelet counts, prednisone is appropriate for Bell palsy, and tiotropium is suitable for COPD despite pneumonia.
The nurse is talking with the parent of a 2-year-old client who has a sunburn across the back and shoulders. Which of the following statements by the parent would indicate a correct understanding of sunburn care? Select all that apply.
- A. I will encourage my child to drink extra fluids.
- B. I will give my child aspirin to help relieve pain.
- C. I can allow my child to play outdoors with adequate sun protection.
- D. I can place cool compresses on my child's back to decrease discomfort
- E. I will apply hydrocortisone cream to the affected area and cover it with gauze dressings.
Correct Answer: A,C,D
Rationale: Extra fluids prevent dehydration, cool compresses soothe skin, and outdoor play with protection (sunscreen, clothing) is safe. Aspirin is avoided in children due to Reye's syndrome risk. Hydrocortisone isn't standard for sunburn; aloe or moisturizers are preferred.