Nokea
What health promotion teaching should prioritize to prevent drug-induced hepatitis?
- A. Finish all prescribed courses of antibiotics, regardless of symptom resolution
- B. Adhere to dosing recommendations of over-the-counter analgesics
- C. Ensure that expired medications are disposed of safely
- D. Ensure that pharmacists regularly review drug regimens for potential interactions
Correct Answer: B
Rationale: The correct answer is B because adhering to dosing recommendations of over-the-counter analgesics can help prevent drug-induced hepatitis by avoiding potential liver damage from excessive doses. Over-the-counter analgesics like acetaminophen can be hepatotoxic if taken in high amounts. Finishing all prescribed courses of antibiotics (A) is important for antibiotic resistance but does not specifically prevent drug-induced hepatitis. Ensuring safe disposal of expired medications (C) is crucial for environmental safety but does not directly prevent drug-induced hepatitis. Having pharmacists review drug regimens for potential interactions (D) is important for overall medication safety but does not specifically address the prevention of drug-induced hepatitis.
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A client who is acutely ill has vigilant oral care included in their plan of care. What factor increases this client's risk for dental caries?
- A. Hormonal changes induced by the stress response leading to an acidic oral environment
- B. Systemic infections commonly affecting the teeth
- C. Intravenous hydration lacking fluoride
- D. Inadequate nutrition and reduced saliva production contributing to cavities
Correct Answer: D
Rationale: The correct answer is D because inadequate nutrition and reduced saliva production contribute to cavities. In acute illness, the client may not be able to consume a balanced diet, leading to nutrient deficiencies that weaken teeth. Reduced saliva flow decreases the mouth's ability to naturally clean and protect teeth. Choices A, B, and C are incorrect because hormonal changes from stress do not directly lead to acidic oral environment, systemic infections do not commonly affect teeth, and lack of fluoride from intravenous hydration is not a primary factor for dental caries.
A client's health history is suggestive of inflammatory bowel disease. Which of the following would suggest Crohn disease, rather than ulcerative colitis, as the cause of the client's signs and symptoms?
- A. A pattern of distinct exacerbations and remissions
- B. Severe diarrhea
- C. An absence of blood in stool
- D. Involvement of the rectal mucosa
Correct Answer: C
Rationale: The correct answer is C: An absence of blood in stool. This suggests Crohn's disease over ulcerative colitis because Crohn's can involve any part of the GI tract and may not always present with blood in stool, in contrast to ulcerative colitis which typically involves the rectum and almost always presents with blood in stool due to continuous inflammation in the colon. Choices A, B, and D are more commonly associated with ulcerative colitis, which typically presents with a pattern of exacerbations and remissions, severe diarrhea, and rectal mucosal involvement.
A client returns to the unit after a neck dissection. The surgeon placed a Jackson-Pratt drain in the wound. When assessing the wound drainage over the first 24 postoperative hours, what finding would prompt the nurse to notify the health care provider immediately?
- A. Presence of small blood clots in the drainage
- B. 60 mL of milky or cloudy drainage
- C. Spots of drainage on the dressings surrounding the drain
- D. 120 mL of serosanguinous drainage
Correct Answer: B
Rationale: The correct answer is B: 60 mL of milky or cloudy drainage. This finding could indicate the presence of an infection, which is a serious complication post-neck dissection. Milky or cloudy drainage may contain pus, indicating the need for immediate intervention to prevent further complications.
A: Presence of small blood clots in the drainage is relatively common and may not necessarily indicate a problem unless there are large clots or excessive bleeding.
C: Spots of drainage on the dressings surrounding the drain are expected and do not necessarily warrant immediate notification unless there is excessive leakage.
D: 120 mL of serosanguinous drainage is within the expected range for the first 24 hours postoperatively and may not be a cause for immediate concern unless there are other symptoms present.
A 35-year-old woman presents with fatigue, weight gain, and cold intolerance. Laboratory tests reveal high TSH and low free T4 levels. What is the most likely diagnosis?
- A. Hypothyroidism
- B. Hyperthyroidism
- C. Thyroiditis
- D. Thyroid cancer
Correct Answer: A
Rationale: The correct answer is A: Hypothyroidism. The patient's symptoms of fatigue, weight gain, and cold intolerance are classic signs of hypothyroidism. Elevated TSH and low free T4 levels indicate primary hypothyroidism. TSH is high due to the pituitary gland trying to stimulate the thyroid gland to produce more thyroid hormones, but the thyroid gland is unable to do so. Hyperthyroidism (choice B) would present with opposite symptoms and lab values. Thyroiditis (choice C) typically presents with transient hyperthyroidism followed by hypothyroidism. Thyroid cancer (choice D) is less common and typically does not present with these typical hypothyroid symptoms and lab findings.
After a client with ascites due to liver cirrhosis undergoes a paracentesis, what should the nurse do post-procedure?
- A. Encourage the client to drink plenty of fluids
- B. Monitor the client's blood pressure and heart rate
- C. Position the client flat on their back
- D. Administer a dose of furosemide
Correct Answer: B
Rationale: The correct answer is B: Monitor the client's blood pressure and heart rate. Post-paracentesis, there is a risk of hypotension due to sudden fluid shift. Monitoring BP and HR is crucial to detect and manage any hemodynamic changes promptly. Encouraging fluid intake (choice A) may exacerbate ascites. Positioning flat (choice C) may lead to hypotension. Administering furosemide (choice D) without monitoring vital signs can worsen hypotension.