Nokea
A client taking Zoloft (sertraline) tells the nurse that she has also been taking St. John's wort. The nurse should report this information to the doctor because:
- A. The two substances have opposing effects.
- B. The amount of medication may be reduced.
- C. Herbals only provide a placebo effect.
- D. It will be necessary to increase the dosage.
Correct Answer: B
Rationale: St. John's wort can induce the metabolism of Zoloft, potentially reducing its effectiveness, so the doctor may need to adjust the dose. Answer A is incorrect as they do not have opposing effects. Answer C is incorrect as St. John's wort has pharmacological effects. Answer D is incorrect as increasing the dose may not be necessary.
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The emergency room nurse admits a child who experienced a seizure at school. The parent comments that this is the first occurrence and denies any family history of epilepsy. What is the best response by the nurse?
- A. Do not worry. Epilepsy can be treated with medications.
- B. The seizure may or may not mean your child has epilepsy.
- C. Since this was the first convulsion, it may not happen again.
- D. Long term treatment will prevent future seizures.
Correct Answer: B
Rationale: The seizure may or may not mean your child has epilepsy. A single seizure has multiple potential causes, not necessarily epilepsy.
A patient has recently been prescribed Lidocaine Hydrochloride. Which of the following symptoms may occur with over dosage?
- A. Memory loss and lack of appetite
- B. Confusion and fatigue
- C. Heightened reflexes
- D. Tinnitus and spasticity
Correct Answer: B
Rationale: Lidocaine Hydrochloride can cause fatigue and confusion if an over dosage occurs.
When planning care for a woman who is admitted in labor, it is most important for the nurse to obtain which of the following information about the client?
- A. Age of the client and due date
- B. Frequency and duration of contractions
- C. Whether the membranes have ruptured
- D. Who will be assisting the woman during labor
Correct Answer: B
Rationale: Contraction frequency and duration indicate labor progress and urgency, guiding immediate care. Age, due date, membrane status, and support persons are secondary.
A client is being discharged with plans to return home alone. The client cannot get up from a chair without help and is very unsteady when standing, even with a walker. The nurse expresses concern, but the primary health care provider is adamant that the client be discharged today. Which team member would be most appropriate to assist the nurse in advocating for this client?
- A. Clinical psychologist
- B. Occupational therapist
- C. Physical therapist
- D. Social worker
Correct Answer: D
Rationale: The client’s mobility limitations and unsafe discharge plan require advocacy for alternative arrangements, such as home care or facility placement. A social worker (D) specializes in coordinating resources, assessing home safety, and advocating for patient needs, making them the best team member to assist. A psychologist (A) focuses on mental health, while occupational (B) and physical therapists (C) address functional skills but not discharge planning.
The clinic nurse cares for a 4-year-old who has been diagnosed with a pinworm infection. Which client symptom supports this diagnosis?
- A. Anal itching that is worse at night
- B. Intestinal bleeding with anemia
- C. Poor appetite with weight loss
- D. Red, scaly, blistered rings on skin
Correct Answer: A
Rationale: Pinworms cause anal itching, worse at night (A), due to female worms laying eggs. Bleeding (B), appetite loss (C), and skin lesions (D) are not typical, suggesting other conditions like hookworms or dermatitis.