Nokea
A client has had same-day surgery to insert a ventilating tube into the tympanic membrane. Which statement assures the nurse that the client understands the discharge instructions?
- A. I will use a shower cap when taking a shower.
- B. I was told to try and avoid taking medications for pain.
- C. I need to wash my hair quickly; taking 2 minutes or less.
- D. Swimming is allowed only if I keep my head above water.
Correct Answer: A
Rationale: After the insertion of tubes into the tympanic membrane, it is important to avoid getting water in the ears. A shower cap or earplug may be used when showering if allowed by the primary health care provider. Swimming, showering without a shower cap or ear plugs, and washing the hair are avoided after surgery until the time frame designated for each is identified by the surgeon. The client should take medication as advised for postoperative discomfort.
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A client with a short leg plaster cast reports intense itching under the cast. The nurse provides instructions to the client regarding relief measures for the itching. Which statement by the client indicates an understanding of the measures used to relieve the itching?
- A. I can use the blunt part of a ruler to scratch the area.
- B. I can trickle small amounts of water down inside the cast.
- C. I need to obtain assistance when placing an object into the cast for the itching.
- D. I can use a hair dryer on the low setting and allow the air to blow into the cast.
Correct Answer: D
Rationale: Itching is a common complaint of clients with casts. Objects should not be put inside a cast because of the risk of scratching the skin and providing a point of entry for bacteria. A plaster cast can break down when wet. Therefore, the best way to relieve itching is with the forceful injection of air inside the cast.
A client is receiving intravenous (IV) antibiotic therapy at home via an intermittent IV catheter. In order to facilitate the early detection of IV therapy complications, which intervention should be included in the client's education?
- A. Protect the IV site continually.
- B. Keep the IV site clean and dry.
- C. Report local pain, drainage, or edema.
- D. Apply pressure to the IV site if it dislodges.
Correct Answer: C
Rationale: The nurse instructs the client to report clinical indicators of an IV site infection, including pain, drainage, and edema because the early detection of infection decreases the risk of septicemia, tissue loss, and devastating complications. The remaining options are reasonable aspects of client teaching for IV therapy at home, but they are not surveillance methods.
The nurse is giving dietary instructions to a client who has been prescribed cyclosporine. Which statement by the client indicates the need for further teaching?
- A. Red meats are alright to eat.
- B. Orange juice is a great choice for breakfast.
- C. Grapefruit juice will not interfere with the medication.
- D. Green leafy vegetables should be eaten as often as possible.
Correct Answer: C
Rationale: A compound in grapefruit juice inhibits the metabolism of cyclosporine. Thus, drinking grapefruit juice can raise cyclosporine levels by 50% to 100%, greatly increasing the risk of toxicity. The foods in options 1, 2, and 4 are acceptable to consume.
The nurse performs an initial assessment on a pregnant client and determines that the client is at risk for toxoplasmosis. The nurse provides education to the client on how to prevent the disease. Which statement by the client indicates that teaching has been effective?
- A. It's alright to eat raw meats.
- B. I should wash hands only before meals.
- C. I should avoid exposure to litter boxes used by my cat.
- D. I should use topical corticosteroid treatments prophylactically.
Correct Answer: C
Rationale: Infected house cats transmit toxoplasmosis through the feces. Handling litter boxes can transmit the disease to the pregnant client. Meats that are undercooked can harbor microorganisms that can cause infection. Hands should be washed frequently throughout the day. The use of topical corticosteroids will not prevent exposure to the disease.
The nurse is reviewing written medication instructions with a client who is prescribed colestipol hydrochloride. Which statement by the client indicates that the teaching has been effective?
- A. Vitamin C will help control unintended side effects.
- B. Vitamin B12 will help control unintended side effects.
- C. B-complex vitamins will help control unintended side effects.
- D. Fat-soluble vitamins will help control unintended side effects.
Correct Answer: D
Rationale: Colestipol hydrochloride, which is a bile-sequestering agent, is used to lower blood cholesterol levels. However, the bile salts (which are rich in cholesterol) interfere with the absorption of the fat-soluble vitamins A, D, E, and K, as well as folic acid. With ongoing therapy, the client is at risk for the deficiency of these vitamins and is counseled to take them as supplements.