Nokea
A client with a history of chronic obstructive pulmonary disease (COPD) is prescribed budesonide (Pulmicort). The nurse should instruct the client to:
- A. Rinse the mouth after inhalation.
- B. Use the inhaler as needed for shortness of breath.
- C. Take the inhaler with meals.
- D. Stop the inhaler if dizziness occurs.
Correct Answer: A
Rationale: Rinsing the mouth after budesonide inhalation prevents oral thrush.
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A nurse notices that a newborn has a swelling in the scrotum. The nurse should interpret this as indicative of hydrocele if which of the following occurs?
- A. The swollen bulge can be reduced.
- B. The increase in scrotal size is bilateral.
- C. The scrotal sac can be transilluminated.
- D. The bulge appears during crying.
Correct Answer: C
Rationale: Transillumination of the scrotal sac indicates fluid, characteristic of a hydrocele, a common newborn condition.
A client with a history of chronic pain is prescribed gabapentin (Neurontin). The nurse should instruct the client to report which of the following side effects?
- A. Drowsiness.
- B. Hypertension.
- C. Hyperglycemia.
- D. Tachycardia.
Correct Answer: A
Rationale: Gabapentin commonly causes drowsiness, which should be reported to manage safety and dosing.
After several months of taking olanzapine (Zyprexa), the client reports that he is no longer hearing voices of any kind. Which of the following would confirm that the client is developing insight into his illness?
- A. That Zyprexa is the best medicine I have ever had.'
- B. I didn't realize how sick I could get from a chemical brain imbalance.'
- C. My mom is proud of me for staying on my medicines.'
- D. I think I may be able to get a little part-time job soon.'
Correct Answer: B
Rationale: Acknowledging a chemical brain imbalance shows insight into the biological basis of the illness, indicating understanding of the need for treatment.
A client with a history of cirrhosis is admitted with jaundice. The nurse should include which of the following in the plan of care?
- A. Monitor for signs of bleeding.
- B. Encourage a high-fat diet.
- C. Administer vitamin C.
- D. Restrict protein intake.
Correct Answer: A
Rationale: Jaundice in cirrhosis indicates liver dysfunction, increasing bleeding risk due to impaired clotting factor production.
A family has taken home their newborn and later received a call from the pediatrician that the PKU levels for their newborn daughter are abnormally high. Additional testing confirmed the diagnosis of phenylketonuria. The parents refuse to believe the results as no one else in their family has the disease. The nurse explains that the disease:
- A. Is carried on recessive genes contributed by each parent.
- B. Is caused by a recessive gene contributed by either parent.
- C. Is cured by eliminating dietary protein for this child.
- D. Will not impact future childbearing for the family.
Correct Answer: A
Rationale: Phenylketonuria is an autosomal recessive disorder, requiring both parents to contribute a defective gene. It is not caused by a single parent's gene, cannot be cured by diet alone (though managed by low-phenylalanine diet), and may impact future childbearing as parents are carriers.