Nokea
A 7-year-old child is admitted to the hospital with acute rheumatic fever. When discussing long-term care for the child with the parents, the nurse should teach them that a necessary part of this care is:
- A. Physical therapy.
- B. Antibiotic therapy.
- C. Psychological therapy.
- D. Anti-inflammatory therapy.
Correct Answer: B
Rationale: Antibiotic therapy is essential for acute rheumatic fever to eradicate streptococcal infection and prevent recurrence, which is critical for long-term management.
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Neuroleptic malignant syndrome is suspected in a client who is prescribed an atypical antipsychotic medication. Which medication should the nurse prepare in anticipation of being prescribed to treat this adverse effect related to the use of this medication?
- A. Bromocriptine
- B. Protamine sulfate
- C. Enalapril maleate
- D. Phytonadione (vitamin K)
Correct Answer: A
Rationale: Bromocriptine is a dopamine pathway medication used in the treatment of neuroleptic malignant syndrome. Protamine sulfate is the antidote for heparin overdose. Vitamin K is the antidote for warfarin overdose. Enalapril maleate is an angiotensin-converting enzyme inhibitor and an antihypertensive that is used in the treatment of hypertension.
The nurse inserting an oropharyngeal airway into an assigned client should plan to use which insertion procedure?
- A. Flexing the client's neck
- B. Leaving dentures in place
- C. Suctioning the client's mouth only if prescribed
- D. Inserting the airway with the tip pointed upward
Correct Answer: D
Rationale: The airway is inserted with the tip pointed upward and is then rotated downward once the flange has reached the client's teeth. The client should be positioned supine, with the neck hyperextended if possible. Before insertion of an oropharyngeal airway, any dentures or partial plates should be removed from the client's mouth. After insertion, the client's mouth is suctioned every hour or as necessary. The airway is removed for inspection of the mouth every 2 to 4 hours.
An 80-year-old client with severe kidney damage is placed on life support and dialysis. Care decisions are being made by his wife, who is showing signs of early Alzheimer's disease. The client's daughter arrives from out of town with a copy of the client's living will, which states that the client did not want to be on life support. The nurse should:
- A. Immediately inform the physician about the living will.
- B. Suggest to the daughter that she discuss her father's wishes with her mother.
- C. Prepare to remove the client from life support.
- D. Make a copy of the living will and give it to the client's wife.
Correct Answer: A
Rationale: Informing the physician about the living will ensures that the client's wishes are addressed promptly.
Intussusception occurs when:
- A. Part of the intestine slides into another part of the intestine.
- B. The appendix ruptures.
- C. An ileostomy stoma retracts below the abdominal surface.
- D. Lungs are infiltrated.
Correct Answer: A
Rationale: Intussusception is a condition where one segment of the intestine telescopes into another, causing obstruction, most commonly in children.
A client has his leg immobilized in a long leg cast. Which of the following assessments indicates the early beginning of circulatory impairment?
- A. Inability to move toes.
- B. Cyanosis of toes.
- C. Complaints of cast tightness.
- D. Tingling of toes.
Correct Answer: D
Rationale: Tingling is an early sign of circulatory impairment due to nerve compression from swelling or tight casting, requiring prompt attention.