Nokea
A client with a history of epilepsy is prescribed lamotrigine (Lamictal). The nurse should instruct the client to report which of the following side effects immediately?
- A. Mild headache.
- B. Rash.
- C. Nausea.
- D. Fatigue.
Correct Answer: B
Rationale: A rash may indicate a serious hypersensitivity reaction to lamotrigine, such as Stevens-Johnson syndrome, requiring immediate reporting.
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Which statement about total parenteral nutrition is true?
- A. Clients are at high risk for infection when they are getting TPN because they are immunocompromised.
- B. Clients are at high risk for hyperglycemia when they are getting TPN because they are diabetic.
- C. The client should perform the Valsalva maneuver when the nurse changes the TPN tubing.
- D. The client should perform the Valsalva maneuver when the nurse changes the TPN dressing.
Correct Answer: C
Rationale: The Valsalva maneuver is used when changing TPN tubing to prevent air embolism by increasing intrathoracic pressure.
The charge nurse on the postpartum unit has received report about a client with a fetal demise who has just delivered and will be ready for transfer out of Labor and Delivery in about 2 hours. The client has asked her primary nurse if she can stay on the unit since she found support from the nursing staff there. What action should the charge nurse on the postpartum unit take?
- A. Request a room for this client on a unit without newborns.
- B. Ask the nurse in labor and delivery to discharge the mother as soon as she is physically able to leave.
- C. Talk to the mother first and decide on a location that is mutually agreeable.
- D. Admit the mother to a private room on the postpartum unit.
Correct Answer: A
Rationale: Placing the client on a unit without newborns minimizes emotional distress from being near other newborns after a fetal demise.
A client with Parkinson's disease is prescribed levodopa-carbidopa (Sinemet). The nurse should instruct the client to:
- A. Take the medication on an empty stomach.
- B. Avoid vitamin B6 supplements.
- C. Take the medication with a high-protein meal.
- D. Stop the medication if dizziness occurs.
Correct Answer: B
Rationale: Vitamin B6 can reduce the effectiveness of levodopa, so clients should avoid B6 supplements.
A client is admitted to the hospital with a tentative diagnosis of urinary tract infection (UTI). The nurse should assess the client for which of the following as a precipitating factor for the UTI?
- A. High fluid intake.
- B. History of hypertension.
- C. Recent antibiotic therapy.
- D. Frequent sexual intercourse.
Correct Answer: D
Rationale: Frequent sexual intercourse is a common precipitating factor for UTIs, as it can introduce bacteria into the urinary tract.
Your client in crisis is detaching from self. Which psychological ego defense mechanism is this client most likely using?
- A. Displacement
- B. Sublimation
- C. Dissociation
- D. Reaction formation
Correct Answer: C
Rationale: Dissociation is the defense mechanism where a person detaches from their sense of self or reality to cope with overwhelming stress or trauma, which aligns with the client's behavior.