Nokea
A client is in the family medicine clinic reporting a dry, sore throat. The provider asks the nurse to assess for odynophagia. What assessment technique is most appropriate?
- A. Ask the client what foods cause trouble swallowing.
- B. Observe the client's throat for redness.
- C. Perform a throat culture immediately.
- D. Check the client's temperature.
Correct Answer: A
Rationale: Odynophagia refers to painful swallowing. Asking the client what foods cause trouble swallowing is the most direct way to assess for this condition.
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A client has been hospitalized with tuberculosis (TB). The client's spouse is fearful of entering the room where the client is in isolation and refuses to visit. What action by the nurse is best?
- A. Ask the spouse to explain the fear of visiting in further detail.
- B. Inform the spouse the precautions are meant to keep other clients safe.
- C. Show the spouse how to follow the isolation precautions to avoid illness.
- D. Tell the spouse that he or she has already been exposed, so it's safe to visit.
Correct Answer: A
Rationale: The nurse needs to obtain further information about the spouse's specific fears so they can be addressed. This will decrease stress and permit visitation, which will be beneficial for both client and spouse.
A client has the diagnosis of valley fever accompanied by myalgias and arthralgias. What treatment should the nurse educate the client on?
- A. Intravenous amphotericin B.
- B. Long-term anti-inflammatories.
- C. No specific treatment.
- D. Oral fluconazole (Diflucan).
Correct Answer: D
Rationale: Valley fever, or coccidioidomycosis, is a fungal infection. The presence of joint and muscle pain indicates a moderate infection that needs treatment with antifungal medications like oral fluconazole.
A client has been taking isoniazid (INH) for tuberculosis for 3 weeks. What laboratory results need to be reported to the health care provider immediately?
- A. Albumin: 5.1 g/dL.
- B. Alanine aminotransferase (ALT): 180 U/L.
- C. Red blood cell (RBC) count: 5.2 million/mm³.
- D. White blood cell (WBC) count: 12,500/mm³.
Correct Answer: B
Rationale: INH can cause liver damage, especially if the client drinks alcohol. The ALT (one of the liver enzymes) is extremely high and needs to be reported immediately, as it indicates potential liver toxicity.
A client is in the family practice clinic reporting a severe cold that started 4 days ago. On examination, the nurse notes the client also has a severe headache and muscle aches. What action by the nurse is best?
- A. Educate the client on oseltamivir (Tamiflu).
- B. Facilitate admission to the hospital.
- C. Instruct the client to have a flu vaccine.
- D. Teach the client to sneeze in the upper sleeve.
Correct Answer: D
Rationale: Sneezing and coughing into one's sleeve helps prevent the spread of upper respiratory infections. Given the client's symptoms and the need to prevent further transmission, this is the most appropriate action.
A client is in the family practice clinic reporting a severe cough that has lasted for 5 weeks. The client is so exhausted after coughing that work has become impossible. What action by the nurse is most appropriate?
- A. Arrange for immediate hospitalization.
- B. Facilitate polymerase chain reaction testing.
- C. Have the client produce a sputum sample.
- D. Obtain two sets of blood cultures.
Correct Answer: B
Rationale: Polymerase chain reaction testing is used to diagnose pertussis, which this client is showing manifestations of. This is the most appropriate action to confirm the diagnosis.