Nokea
A 10-year-old client is diagnosed with infectious mononucleosis. Her white blood cell (WBC) count is 19,000/µL. She has a streptococcal throat infection and her spleen is enlarged. She has aching muscles. Which of the following instructions should the nurse include in discharge planning with the client and the essential caregiver? Select all that apply.
- A. Stay on bed rest until the temperature is normal.
- B. Gargle with warm saline while the throat is irritated.
- C. Increase intake of fluids until the infection subsides.
- D. Take aspirin as long as the fever and myalgia persist.
- E. Avoid contact sports while the spleen is enlarged.
Correct Answer: B,C,E
Rationale: Infectious mononucleosis with an enlarged spleen requires avoiding contact sports to prevent splenic rupture, a serious complication. Gargling with warm saline soothes the throat, and increased fluids support recovery and prevent dehydration. Bed rest is not strictly necessary unless fever persists, and aspirin should be avoided in children due to the risk of Reye's syndrome.
You may also like to solve these questions
A client with a fractured right femur has not had any immunizations since childhood. Which of the following biological products should the nurse administer to provide the client with passive immunity for tetanus?
- A. Tetanus toxoid.
- B. Tetanus antigen.
- C. Tetanus vaccine.
- D. Tetanus antitoxin.
Correct Answer: D
Rationale: Tetanus antitoxin provides passive immunity, neutralizing existing toxin in unvaccinated clients.
A client with acute renal failure has a low calcium level. The nurse should monitor for:
- A. Tetany.
- B. Hypertension.
- C. Bradycardia.
- D. Edema.
Correct Answer: A
Rationale: Low calcium can cause tetany, manifesting as muscle cramps or spasms.
Peripheral blood flow is dependent on which of the following variables?
- A. Blood viscosity and diameter of vessels
- B. Diameter and resistance of vessels
- C. Force of contraction of the heart and resistance of vessels
- D. Pressure differences in the arterial and venous systems and resistance
Correct Answer: D
Rationale: Peripheral blood flow depends on pressure differences between the arterial and venous systems (driving force) and vascular resistance (opposing force). This relationship is governed by Poiseuille's law and Ohm's law for fluid flow, where flow is proportional to the pressure gradient and inversely proportional to resistance. The other options are incomplete or incorrect combinations of factors.
While the nurse is providing preoperative teaching, the client says, 'I hate the idea of being an invalid after they cut off my leg.' The nurse's most therapeutic response should be:
- A. You'll still have one good leg to use.'
- B. Tell me more about how you're feeling.'
- C. Let's finish the preoperative teaching.'
- D. You're fortunate to have a wife who can take care of you.'
Correct Answer: B
Rationale: The therapeutic response, 'Tell me more about how you're feeling,' encourages the client to express fears and concerns, facilitating emotional support and coping. The other responses dismiss the client's feelings, prioritize teaching, or make assumptions, which are less therapeutic.
A client reports that she has gained weight and that her face and body are 'rounder,' while her legs and arms have become thinner. A tentative diagnosis of Cushing's disease is made. When examining this client, the nurse would expect to find:
- A. Orthostatic hypotension.
- B. Muscle hypertrophy in the extremities.
- C. Bruised areas on the skin.
- D. Decreased body hair.
Correct Answer: C
Rationale: Cushing's disease causes thin, fragile skin due to excess cortisol, leading to easy bruising.