Nokea
A 16-year-old, 165-pound patient reports consuming 20-40 325-mg capsules containing acetaminophen 1 hour ago. You should
- A. measure the plasma level and determine potential toxicity from the level on the nomogram
- B. wait until 4 hours after ingestion to measure the plasma level and do nothing else
- C. administer activated charcoal immediately and measure the plasma level of acetaminophen 4 hours after ingestion
- D. send the patient home because an ingestion of this magnitude is not toxic
Correct Answer: C
Rationale: Activated charcoal can help reduce absorption of acetaminophen, and plasma levels should be measured 4 hours post-ingestion to assess toxicity using the nomogram.
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The nurse observes that a new mother avoids making eye contact with her newborn. The nurse should perform which action?
- A. Examine newborn's eyes for ability to focus.
- B. Assess for other attachment behaviors.
- C. Recognize this as a common reaction in new mothers.
- D. Ask mother why she won't look at newborn.
Correct Answer: B
Rationale: The nurse should assess for other attachment behaviors when a new mother avoids making eye contact with her newborn. This behavior may indicate difficulty forming an emotional bond with the newborn, which can impact the mother-infant relationship. By assessing for other attachment behaviors, the nurse can gather more information to understand the mother's response and provide appropriate support and interventions. Simply recognizing this as a common reaction or asking the mother why she won't look at the newborn may not address the underlying attachment issues that may be present. Examining the newborn's eyes for ability to focus is not relevant in this situation and does not address the mother's behavior.
The most significant form of meningitis is:
- A. Bacterial
- B. Septic
- C. Aseptic
- D. Viral
Correct Answer: A
Rationale: Bacterial meningitis is considered the most significant form of meningitis because it is a serious, life-threatening condition that requires immediate medical attention. Bacterial meningitis is caused by bacteria infecting the protective membranes covering the brain and spinal cord. It can lead to complications such as brain damage, hearing loss, and even death if not treated promptly with antibiotics. Bacterial meningitis is more severe than viral or aseptic meningitis, hence why it is considered the most significant form.
Alveolar type of rhabdomyosarcoma accounts for approximately 1/3 of all cases of pediatric RMS and carries the poorest prognosis. Of the following, the MOST common site of involvement by alveolar type RMS is
- A. orbit
- B. middle ear
- C. extremities
- D. bladder
Correct Answer: C
Rationale: Extremities are the most common site for alveolar rhabdomyosarcoma.
The nurse is teaching a client with type 1 diabetes mellitus how to treat adverse reactions to insulin. To reverse a hypoglycemic reaction, the client ideally should ingest an oral carbohydrate. However, this treatment isn't always a possible or safe. Therefore, the nurse should advise the client to keep which alternate treatment on hand?
- A. Epinephrine
- B. 50% dextrose
- C. Glucagon
- D. Hydrocortisone
Correct Answer: C
Rationale: Glucagon is the hormone responsible for raising blood sugar levels in the body. In cases of severe hypoglycemic reactions where the client is unconscious or unable to ingest oral carbohydrates, glucagon can be administered via injection to help raise blood sugar levels rapidly. It is important for clients with type 1 diabetes mellitus to have glucagon on hand as a precautionary measure in case of severe hypoglycemic episodes. Epinephrine is typically used for severe allergic reactions, 50% dextrose is a form of oral carbohydrate, and hydrocortisone is a corticosteroid medication used for various conditions but not for treating hypoglycemia in clients with diabetes.
A client takes prednisone (Deltasone), as prescribed, for rheumatoid arthritis. During follow-up visits, the nurse should assess the client for common adverse reactions to this drug, such as:
- A. Tetany and tremors
- B. Fluid retention and weight gain
- C. Anorexia and weight loss
- D. None of the above
Correct Answer: B
Rationale: Prednisone, or Deltasone, is a corticosteroid medication commonly prescribed for conditions like rheumatoid arthritis. One of the common adverse reactions to corticosteroids like prednisone is fluid retention and weight gain. This can occur due to the drug's effect on sodium and water retention in the body, leading to edema and increased body weight. Monitoring for signs of fluid retention, such as swelling in the extremities, and weight changes is important during follow-up visits to ensure the client's well-being and to address any concerns promptly. Tetany and tremors (choice A) are not typically associated with prednisone use, and anorexia and weight loss (choice C) are not common adverse reactions but rather less common side effects of prednisone.