Nokea
A client taking Dilantin (phenytoin) for tonic-clonic seizures is preparing for discharge. Which information should be included in the client's discharge care plan?
- A. The medication can cause dental staining.
- B. The client will need to avoid a high-carbohydrate diet.
- C. The client will need a regularly scheduled blood work.
- D. The client will need a regularly scheduled blood work.
Correct Answer: C
Rationale: Phenytoin requires regular blood work to monitor levels and prevent toxicity, which can cause side effects like gingival hyperplasia.
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The physician has prescribed Chloromycetin (chloramphenicol) for a client with bacterial meningitis. Which lab report should the nurse monitor most carefully?
- A. Serum creatinine
- B. Urine specific gravity
- C. Complete blood count
- D. Serum sodium
Correct Answer: C
Rationale: Chloramphenicol can cause bone marrow suppression, so monitoring the complete blood count is critical.
The nurse is assessing a client hospitalized with duodenal ulcer. Which finding should be reported to the doctor immediately?
- A. BP 82/60, pulse 120
- B. Pulse 68, respirations 24
- C. BP 110/88, pulse 56
- D. Pulse 82, respirations 16
Correct Answer: A
Rationale: A blood pressure of 82/60 and pulse of 120 indicate possible hypovolemic shock, likely due to gastrointestinal bleeding, which is a medical emergency requiring immediate reporting.
The 5-year-old is being tested for enterobiasis (pinworms). To collect a specimen for assessment of pinworms, the nurse should teach the mother to:
- A. Place tape on the child's perianal area before putting the child to bed
- B. Scrape the skin with a piece of cardboard and bring it to the clinic
- C. Obtain a stool specimen in the afternoon
- D. Bring a hair sample to the clinic for evaluation
Correct Answer: A
Rationale: The tape test, applied to the perianal area at night or early morning, is the standard method to collect pinworm eggs.
A client is being evaluated for carpel tunnel syndrome. The nurse is observed tapping over the median nerve in the wrist and asking the client if there is pain or tingling. Which assessment is the nurse performing?
- A. Phalen's maneuver
- B. Tinel's sign
- C. Kernig's sign
- D. Brudzinski's sign
Correct Answer: B
Rationale: Tinel's sign involves tapping over the median nerve to elicit pain or tingling, indicating carpal tunnel syndrome. Phalen's maneuver involves wrist flexion, and the others assess meningitis.
A child who weighs 40 kg is prescribed clarithromycin 15 mg/kg per day for 10 days in two divided doses for acute strep throat. If the medication is provided in suspension with 250 mg/5 mL, how many total milliliters of medication are required to complete the treatment? Record your answer using a whole number.
Correct Answer: 120
Rationale: Daily dose = 15 mg/kg X 40 kg = 600 mg/day. For 10 days, total dose = 600 X 10 = 6,000 mg. Suspension is 250 mg/5 mL, so 1 mg = 0.02 mL. Thus, 6,000 mg X 0.02 mL/mg = 120 mL.