Nokea
A client has a new prescription for timolol and the nurse provides medication instructions to the client. Which statement by the client indicates a need for further teaching regarding the instructions?
- A. I should change positions slowly.
- B. I need to report shortness of breath to the doctor.
- C. I need to taper or discontinue the medication when I feel well.
- D. I have enough medication on hand to last through weekends and vacations.
Correct Answer: C
Rationale: Timolol is a beta-adrenergic blocking agent. The client should not discontinue or change the medication dose. Common client teaching points about beta-adrenergic blocking agents include taking the pulse daily, holding it if the rate is less than 60 beats/min (and notifying the primary health care provider); changing positions slowly; and reporting shortness of breath. The client is also instructed to keep enough medication on hand, not take over-the-counter medications (especially decongestants, cough, and cold preparations) without consulting the primary health care provider, and carry medical identification that states that a beta-blocker is being taken.
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Which problems should the nurse counsel adoptive parents about encountering? Select all that apply.
- A. Setting unrealistically high standard for themselves
- B. Lacking basic knowledge about the child's biological health history
- C. Having difficulty assimilating if the child is adopted from another country
- D. Having difficulty deciding when and how to tell the child about being adopted
- E. Feeling the need for more assistance and support in child-rearing than biological parents do
- F. Dealing with feelings of loss and grief in the child regarding family social history and traditions
Correct Answer: A,B,C,D,F
Rationale: Adoptive parents may add pressure to themselves by setting unrealistically high standards for themselves. Additional problems adoptive families may face include possible lack of knowledge about the child's biological health history, difficulty assimilating if the child is adopted from another country, difficulty deciding when and how to tell the child about being adopted, and dealing with social and traditional issues of the biological family. Otherwise, most problems faced by adoptive parents are no different from those encountered by natural parents. All parents want to be good parents. Both adoptive parents and biological parents need information, support, and guidance to prepare them to care for their child.
The nurse has conducted teaching, with a client who experienced pulmonary embolism, about methods to prevent recurrence after discharge. Which client statement demonstrates understanding of the teaching?
- A. I will limit the intake of fluids.
- B. I will sit down whenever possible.
- C. I am planning to continue to wear supportive hose.
- D. I will cross my legs only at the ankle and not at the knees.
Correct Answer: C
Rationale: Wearing supportive hose enhances venous return, reducing the risk of thrombus formation and pulmonary embolism recurrence. Limiting fluid intake can lead to hemoconcentration, increasing clot risk. Prolonged sitting or crossing legs (even at the ankles) can impede venous return and should be avoided.
A client who is taking tranylcypromine sulfate requests information about foods that are acceptable to eat while taking the medication. Which foods are safe to consume while taking this medication?
- A. Yogurt
- B. Raisins
- C. Oranges
- D. Smoked fish
Correct Answer: C
Rationale: Tranylcypromine sulfate is classified as a monoamine oxidase inhibitor (MAOI); as such, tyramine-containing food should be avoided. Oranges are permissible. Types of food to be avoided include—but are not limited to—yogurt, raisins, and smoked fish. Additionally, beer, wine, caffeinated beverages, pickled meats, yeast preparations, avocados, bananas, and plums are to be avoided.
The nurse is discussing developmental stages with the mother of a six-month-old infant. Which statement indicates an unexpected deviation from normal development?
- A. The infant is walking alone by 15 months.
- B. The infant waves good-bye by 7 months.
- C. The infant rolls from the tummy to the side at 12 months.
- D. The infant transfers a toy from one hand to the other at age 9 months.
Correct Answer: C
Rationale: Rolling tummy to side should occur by 6 months; delay to 12 months is concerning. Other milestones are age-appropriate or expected later.
The nurse is discharging a female client from the hospital who has a diagnosis of a thoracic 11 (T11) fracture with cord transection. The nurse has provided home care instructions to the client. Which action indicates the need for further teaching before discharge?
- A. The client jokes about no longer needing to worry about birth control.
- B. The client states that she will be careful to not eat as many dairy products.
- C. The client verbalizes the need to eat her meals at the same time every day.
- D. The client states that she will wash her hands, her perineum, and the catheter with soap and water before performing self-catheterization.
Correct Answer: A
Rationale: Female spinal cord trauma clients remain fertile during their reproductive years, and contraception is necessary for those who are sexually active. However, oral contraceptives may increase the risk for thrombophlebitis. Clients with paralysis should avoid dairy products to control the formation of urinary calculi. Meals should be eaten at the same time every day, and they should include fiber and warm solid and liquid foods to promote and maintain the regular evacuation of the bowel. Clients who lack bladder control are taught to self-catheterize using clean technique.