Nokea
A client who is receiving cyclosporine (Sandimmune) must practice good oral hygiene, including regular brushing and flossing of the teeth, to minimize gingival hyperplasia during long-term therapy with certain drugs. Which of the following drug falls into this category?
- A. Procainamide (Pronestyl)
- B. Phenytoin (Dilantin)
- C. Azathioprine (Imuran)
- D. Allopurinol (Zyloprim)
Correct Answer: B
Rationale: Gingival hyperplasia, or overgrowth of gum tissue, is a common side effect associated with certain medications, particularly anti-seizure medications like phenytoin (Dilantin). This side effect can be minimized through good oral hygiene practices, such as regular brushing and flossing of the teeth. The client must pay extra attention to oral care while taking phenytoin in order to prevent or reduce the severity of gingival hyperplasia. It is important for healthcare providers to educate clients on the importance of oral hygiene with medications associated with this side effect.
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Wilma is using a portable suction unit at home, What is the amount of suction required by James using this unit?
- A. 2-5 mmHg
- B. 10-15 mmHg
- C. 5-10 mmHg
- D. 20-25 mmHg
Correct Answer: A
Rationale: The amount of suction typically required for routine suctioning for adults using a portable suction unit at home is 80-120 mmHg for an adult patient. However, for children or individuals with sensitive airways, the recommended amount of suction is lower, ranging from 2-5 mmHg. Since the question mentions that James is using the unit at home, it is safer to assume that a lower amount of suction (2-5 mmHg) would be appropriate for his needs.
An infant has been diagnosed with cow's milk allergy. What are the clinical manifestations the nurse expects to assess? (Select all that apply.)
- A. Pink mucous membranes
- B. Vomiting
- C. Rhinitis
- D. Abdominal pain
Correct Answer: B
Rationale: Pink mucous membranes are not a typical clinical manifestation of cow's milk allergy. Allergies often present with symptoms affecting the gastrointestinal tract, respiratory system, skin, or a combination of these systems.
The single parent of a 3-year-old child who has just been diagnosed with chickenpox tells the nurse that she cannot afford to stay home with the child and miss work. The parent asks the nurse if some medication will shorten the course of the illness. Which is the most appropriate nursing intervention?
- A. Reassure the parent that it is not necessary to stay home with the child.
- B. Explain that no medication will shorten the course of the illness.
- C. Explain the advantages of the medication acyclovir (Zovirax) to treat chickenpox.
- D. Explain the advantages of the medication VCZ immune globulin (VariZIG) to treat chickenpox.
Correct Answer: B
Rationale: The most appropriate nursing intervention in this scenario is to explain to the parent that no medication will shorten the course of chickenpox. Chickenpox is a viral illness caused by the varicella-zoster virus, and there is no specific treatment to shorten its duration. Antiviral medications like acyclovir are typically reserved for severe cases or for individuals with compromised immune systems. VCZ immune globulin (VariZIG) is used for post-exposure prophylaxis in susceptible individuals who have been exposed to chickenpox and are at high risk for severe disease.
The nurse should expect a client with hypothyroidism to report which health concerns?
- A. Increased appetite and weight loss
- B. Nervousness and tremors
- C. Puffiness of the face and hands
- D. Thyroid gland swelling
Correct Answer: C
Rationale: Hypothyroidism is characterized by an underactive thyroid gland that does not produce enough thyroid hormone. This hormonal imbalance can lead to symptoms such as slow metabolism, weight gain, fatigue, cold intolerance, constipation, and puffiness of the face and hands. The slowed metabolic rate can also cause fluid retention, resulting in the characteristic puffiness associated with hypothyroidism. Increased appetite and weight loss are not typical symptoms of hypothyroidism, as the condition is more commonly associated with weight gain. Nervousness and tremors are more indicative of hyperthyroidism, where the thyroid gland is overactive. Thyroid gland swelling, known as goiter, can occur in various thyroid disorders but is not specific to hypothyroidism.
An adolescent asks the nurse what causes primary dysmenorrhea. The nurse's response should be based on which statement?
- A. It is an inherited problem.
- B. Excessive estrogen production causes uterine pain.
- C. There is no physiologic cause; it is a psychological reaction.
- D. There is a relation between prostaglandins and uterine contractility.
Correct Answer: D
Rationale: Primary dysmenorrhea is painful menstruation that occurs without any underlying gynecological conditions, such as endometriosis. The cause of primary dysmenorrhea is related to the release of prostaglandins during menstruation. Prostaglandins are lipid compounds that act as chemical messengers in the body, causing the uterus to contract and shed its lining during menstruation. High levels of prostaglandins can lead to increased uterine muscle contractions, resulting in pain. Therefore, the nurse should explain to the adolescent that there is a relation between prostaglandins and uterine contractility as the cause of primary dysmenorrhea.