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A client diagnosed with trigeminal neuralgia asks the nurse what can be done to minimize the episodes of pain. The nurse's response is based on an understanding that what can trigger the pain?
- A. Infection or stress
- B. Hypoglycemia and fatigue
- C. Facial pressure or extreme temperature
- D. Excessive watering of the eyes or nasal stuffiness
Correct Answer: C
Rationale: The paroxysms of pain that accompany this neuralgia are triggered by stimulation of the terminal branches of the trigeminal nerve. Symptoms can be triggered by pressure from washing the face, brushing the teeth, shaving, eating and drinking, and yawning. Symptoms can also be triggered by thermal stimuli such as a draft of cold air. The items listed in the other options do not trigger the spasm.
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The nurse is monitoring a client with a diagnosis of chronic kidney disease (CKD). Which assessment finding should the nurse report to the primary health care provider?
- A. Pallor
- B. Fatigue
- C. Lethargy
- D. Petechiae
Correct Answer: D
Rationale: CKD can cause damage to many body systems. Hematological manifestations that can occur with this disease include anemia and bleeding. Abnormal bleeding (petechiae; purpura; bruising; bleeding from the mucous membranes, nose, or gums; vaginal bleeding; or intestinal bleeding) should be reported to the primary health care provider because it can be life-threatening. Pallor, fatigue, and lethargy are clinical manifestations associated with anemia.
A client with a history of hypothyroidism is prescribed levothyroxine (Synthroid). The nurse should instruct the client to:
- A. Take the medication at bedtime.
- B. Avoid taking the medication with grapefruit juice.
- C. Take the medication with a high-fiber meal.
- D. Stop the medication if palpitations occur.
Correct Answer: B
Rationale: Grapefruit juice can interfere with levothyroxine absorption, so it should be avoided.
Which of the following types of restraints is best for the nurse to use for a child in the immediate postoperative period after cleft palate repair?
- A. Safety jacket.
- B. Elbow restraints.
- C. Wrist restraints.
- D. Body restraints.
Correct Answer: B
Rationale: Elbow restraints are most appropriate post-cleft palate repair to prevent the child from touching or damaging the surgical site while allowing some mobility.
The nurse is planning to teach the client how to properly use a metered-dose inhaler to treat asthma. Which of the following instructions should be included in the teaching?
- A. Rinse the mouth after each use of a steroid inhaler.
- B. Inhale quickly when administering the medication.
- C. Inhale the medication and then exhale through the nose.
- D. Cough and deep-breathe before inhaling the medication.
Correct Answer: A
Rationale: Rinsing the mouth after using a steroid inhaler prevents oral thrush, a common side effect. Quick inhalation, nasal exhalation, or coughing before use are not standard techniques.
A 56-year-old woman is admitted for a modified radical mastectomy. The client appears anxious and asks many questions. The nurse's best course of action is to:
- A. Tell the client as much as she wants to know and is able to understand.
- B. Delay discussing the client's questions with her until the convalescent phase of her care.
- C. Delay discussing the client's questions with her until her apprehension subsides.
- D. Explain to the client that she should discuss her questions with her physician.
Correct Answer: A
Rationale: Addressing the client's questions thoroughly and at her level of understanding reduces anxiety and supports informed consent.