Nokea
A client diagnosed with trichomonal vaginal infection (trichomoniasis) is prescribed metronidazole. Which directions are essential for the nurse to reinforce? Select all that apply.
- A. Avoid alcohol while taking this medication
- B. Perform vaginal douche for 7-10 days
- C. Use birth control pills to prevent infection recurrence
- D. Your partner(s) must be treated simultaneously
- E. Your urine can change to a deep red-brown color
Correct Answer: A,D,E
Rationale: Metronidazole treatment for trichomoniasis requires specific instructions. Avoiding alcohol (A) prevents a disulfiram-like reaction. Partner treatment (D) is essential to prevent reinfection, as trichomoniasis is sexually transmitted. Urine discoloration (E) is a possible side effect to anticipate. Douching (B) is not recommended, as it disrupts vaginal flora. Birth control pills (C) do not prevent recurrence of this infection.
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The nurse is reinforcing teaching to the caregiver of a child diagnosed with ringworm on the abdomen. Which statement by the caregiver indicates a need for further teaching?
- A. Handwashing is very important as ringworm can be spread among humans and pets.
- B. I must apply antifungal cream to all affected areas to eradicate ringworm from the body.
- C. My child has been infected by a worm and must be treated to rid it from the body.
- D. My child may be uncomfortable due to itching, but this is not a dangerous condition.
Correct Answer: C
Rationale: Ringworm is a fungal infection, not a parasitic worm (C), indicating a misunderstanding requiring further teaching. Handwashing (A), antifungal cream (B), and recognizing itching as non-dangerous (D) are correct, reflecting proper understanding.
A client returns from the operating room after a right orchiectomy. For the immediate post-operative period the nursing priority would be to
- A. maintain fluid and electrolyte balance
- B. manage post-operative pain
- C. ambulate the client within 1 hour of surgery
- D. control bladder spasms
Correct Answer: B
Rationale: Due to the location of the incision, pain management is the priority. Bladder spasms are more related to prostate surgery.
Spinal headaches are a common occurrence following spinal anesthesia. Which of the following nursing interventions can help prevent a spinal headache?
- A. Placing the client in a quiet room.
- B. Significantly increasing the client's fluid intake.
- C. Administering PRN pain medication.
- D. Raising the head of the bed to $45^{\circ}$.
Correct Answer: B
Rationale: Increasing fluid intake helps maintain cerebrospinal fluid pressure, reducing the risk of spinal headaches post-spinal anesthesia.
The nurse is reinforcing teaching for a client who is prescribed acyclovir for genital herpes. Which statement should be included by the nurse?
- A. Activated PTT(62%)
- B. Hemotocrit(5%)
- C. Platelets(23%)
- D. PT(8%)
Correct Answer: A
Rationale: Heparin is an anticoagulant that helps prevent further clot formation. It is titrated based on activated partial
thromboplastin time (aPTT). The therapeutic aPTT target is 1.5-2.0 times the normal reference range of 30-40
seconds. A aPTT value >100 seconds would be considered critical and could result in life-threatening side
effects. Common sentinel events that result from heparin drips include epistaxis, hematuria, and gastrointestina
bleeds (Option 1).
(Option 2) A normal hematocrit for a female is 37%-47% (0.37-0.47). In a client with a history of chronic
anemia, a hematocrit of 30% (0.30) may be an expected finding.
(Option 3) A normal platelet count is 150,000-400,000/mm* (150-400 x 10%L). In a client with a history of liver
cirrhosis, a platelet count of 80,000/mmª (80 x 10%/L) would be anticipated. An episode of bleeding rarely occurs
with a platelet count >50,000 mm* (50 x 10%/L).
(Option 4) A normal prothrombin time is 11-12.5 seconds, and so a level of 11 seconds would not be
concerning.
The nurse has reinforced teaching with the parent of a 3-year-old client who has acute diarrhea. Which of the following statements by the parent would require follow-up?
- A. I will apply a skin barrier cream to my child’s diaper area until the diarrhea subsides.
- B. I will encourage my child to drink small amounts of fluids at frequent intervals.
- C. I will feed my child a diet of bananas, rice, applesauce, and toast for the next few days.
- D. I will return to the clinic if I notice a decrease in my child’s urine output.
Correct Answer: C
Rationale: The BRAT diet (C) is outdated and may lack nutrients, risking prolonged recovery. Skin barrier cream (A), frequent fluids (B), and monitoring urine output (D) are appropriate for preventing skin breakdown, dehydration, and detecting complications.