Nokea
A 62-year-old client with a 29-pack per year history is admitted with a diagnosis of the blood pressure. She reports having 'no appetite' and exhibits symptoms of anorexia. The client is 5 feet, 8 inches tall and weighs 112 lb. The client is now scheduled for a left lung lobectomy. Which of the following increases the client's risk of developing postoperative pulmonary complications?
- A. The client tends to keep her real feelings to herself.
- B. The client ambulates and can climb one flight of stairs without dyspnea.
- C. The client is age 62.
- D. The client is 5 feet, 8 inches tall and weighs 112 lb.
Correct Answer: D
Rationale: Low body weight (112 lb for 5'8') indicates malnutrition, increasing the risk of postoperative pulmonary complications.
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When a client states that he is allergic to amoxicillin (Ampicillin) even though his medication administration record and armband do not indicate medication allergies, the nurse should:
- A. Administer the prescribed medication.
- B. Withhold the amoxicillin (Ampicillin).
- C. Administer another, similarly acting antibiotic.
- D. Call the family to verify the client's statement.
Correct Answer: B
Rationale: Withholding the medication is the safest action until the allergy can be verified to prevent an allergic reaction.
A school-age child diagnosed with attention deficit hyperactivity disorder is prescribed methylphenidate (Ritalin). Which of the following should alert the school nurse to the possibility that the child is experiencing a common side effect of the drug?
- A. Loss of appetite
- B. Vomiting
- C. Photosensitivity
- D. Weight gain
Correct Answer: A
Rationale: Loss of appetite is a common side effect of methylphenidate, often leading to weight loss. Vomiting and photosensitivity are less common, and weight gain is not typical.
After 2 days on a psychiatric unit, a client is still isolating himself in his room, except for meals. The client says he is uncomfortable around crowds of people. Which nursing intervention is the most appropriate initially?
- A. Play a game of checkers with the client in his room.
- B. Invite the client to attend a group session with the nurse.
- C. Invite the client to go for a walk with the nurse and one other client.
- D. Talk with the client in a corner of the crafts room.
Correct Answer: C
Rationale: A walk with the nurse and one other client provides a low-pressure social interaction, helping the client gradually build comfort with others while respecting his anxiety about crowds.
A client with a new diagnosis of hypothyroidism is prescribed levothyroxine. What should the nurse include in the teaching plan?
- A. Take the medication at bedtime.
- B. Expect weight gain as a side effect.
- C. Report palpitations or chest pain.
- D. Stop the medication if nausea occurs.
Correct Answer: C
Rationale: Palpitations or chest pain may indicate overmedication or cardiac effects, requiring prompt reporting to adjust the levothyroxine dose.
An adult client has bacterial conjunctivitis. What should the nurse teach him to do? Select all that apply.
- A. Use warm saline soaks four times per day to remove crusting.
- B. Apply topical antibiotic without touching the tip of the tube to his eye.
- C. Wash his hands after touching his eyes.
- D. Avoid touching his eyes.
- E. Observe isolation procedures and confine himself to his bedroom until the redness in the eye disappears.
Correct Answer: A,B,C,D
Rationale: Warm saline soaks, careful antibiotic application, hand washing, and avoiding eye contact prevent spread and promote healing. Isolation is unnecessary unless specified.