Nokea
A 66 year-old client is admitted for mitral valve replacement surgery. The client has a history of mitral valve regurgitation and mitral stenosis since her teenage years. During the admission assessment, the nurse should ask the client if as a child she had
- A. measles
- B. rheumatic fever
- C. hay fever
- D. encephalitis
Correct Answer: B
Rationale: rheumatic fever. Clients that present with mitral stenosis often have a history of rheumatic fever or bacterial endocarditis.
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The client diagnosed with Parkinson's disease is taking levodopa (L-dopa) and is experiencing an 'on/off' effect. Which action should the nurse take regarding this medication?
- A. Document the occurrence and take no action.
- B. Request the HCP to increase the dose of medication.
- C. Discuss the client's imminent death as a result of this complication.
- D. Explain this is a desired effect of the medication.
Correct Answer: A
Rationale: The on/off effect is a known levodopa issue; documenting monitors progression without immediate action. Increasing dose, death discussions, or calling it desired are incorrect.
The provider has ordered daily high doses of aspirin for a client with rheumatoid arthritis. The nurse instructs the client to discontinue the medication and contact the provider if which of the following symptoms occur?
- A. Infection of the gums
- B. Diarrhea for more than one day
- C. Numbness in the lower extremities
- D. Ringing in the ears
Correct Answer: D
Rationale: Ringing in the ears. Aspirin stimulates the central nervous system which may result in ringing in the ears.
The LPN is administering 0800 medications to clients on a medical floor. Which action by the LPN would warrant immediate intervention by the nurse?
- A. The LPN scores the medication to give the correct dose.
- B. The LPN checks the client's armband and birth date.
- C. The LPN administers sliding-scale insulin intramuscularly.
- D. The LPN is 30 minutes late hanging the IV antibiotic.
Correct Answer: C
Rationale: Sliding-scale insulin is given subcutaneously, not IM; this error warrants intervention to prevent improper absorption. Scoring, ID checks, or timing are less critical.
The nurse in the physician's office is instructing an adult about taking penicillin V potassium (Pen-Vee-K) qid. When should the nurse tell him to take the medicine?
- A. With meals and at bedtime
- B. Once a day at 10:00 a.m.
- C. On an empty stomach at six-hour intervals
- D. With orange juice at four-hour intervals
Correct Answer: C
Rationale: Penicillin V potassium should be taken on an empty stomach at six-hour intervals to optimize absorption.
An adult client has pulmonary tuberculosis. He is receiving isoniazid (INH) 300 mg PO, ethambutol 1 g PO daily, and streptomycin 1 g IM three times a week. When he comes in for a checkup, he tells the nurse that he hates getting shots and his ears ring most of the time. What is the best interpretation for the nurse to make regarding the client's complaints?
- A. He may be receiving too much ethambutol.
- B. He should be evaluated for adverse reaction to streptomycin.
- C. Tuberculosis may have spread to the brain.
- D. He is experiencing a reaction commonly seen when INH and streptomycin are given at the same time.
Correct Answer: B
Rationale: Streptomycin is ototoxic, and ringing in the ears (tinnitus) is a sign of potential eighth cranial nerve damage, requiring evaluation.