Nokea
A client with a history of schizophrenia is prescribed clozapine (Clozaril). The nurse should monitor the client for which of the following adverse effects?
- A. Agranulocytosis.
- B. Hyperglycemia.
- C. Bradycardia.
- D. Hypotension.
Correct Answer: A
Rationale: Clozapine can cause agranulocytosis, requiring regular white blood cell monitoring.
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When a breast-feeding mother reports experiencing nipple soreness, the nurse provides teaching regarding measures to relieve the soreness. Which statement by the mother indicates an understanding of the teaching?
- A. I need to avoid rotating breast-feeding positions so that the nipple will toughen.
- B. I need to stop nursing during the period of nipple soreness to allow the nipples to heal.
- C. I need to nurse less frequently and substitute a bottle feeding until the nipples become less sore.
- D. I need to position my infant with her ear, shoulder, and hip in straight alignment and place her stomach against me.
Correct Answer: D
Rationale: Comfort measures for nipple soreness include positioning the infant with the ear, shoulder, and hip in straight alignment and with the infant's stomach against the mother's. Additional measures include rotating breastfeeding positions, breaking suction with the little finger, nursing frequently, beginning feeding on the less sore nipple, not allowing the infant to chew on the nipple or to sleep holding the nipple in the mouth, and applying tea bags soaked in warm water to the nipple. The remaining options are incorrect statements.
A 10-month-old child has cold symptoms. The mother asks how she can clear the infant's nose. Which of the following would be the nurse's best recommendation?
- A. Use a cool air vaporizer with plain water.
- B. Use saline nose drops and then a bulb syringe.
- C. Blow into the child's mouth to clear the infant's nose.
- D. Administer a nonprescription vasoconstrictive nose spray.
Correct Answer: B
Rationale: Saline nose drops followed by bulb syringe suction is safe and effective for clearing nasal congestion in infants. Vaporizers help with humidity, but saline and suction directly clear the nose.
A client with asthma asks the nurse if she should use her salmeterol (Serevent) inhaler when she exercises and experiences wheezing and shortness of breath. The nurse's best response is which of the following?
- A. Yes, use the inhaler immediately for these symptoms.'
- B. No, this drug is a maintenance drug, not a rescue inhaler.'
- C. Use the inhaler 5 minutes before you exercise to prevent the wheezing.'
- D. This inhaler is for allergic rhinitis, not asthma.'
Correct Answer: B
Rationale: Salmeterol is a long-acting beta-agonist used for asthma maintenance, not for acute symptoms like wheezing during exercise. A rescue inhaler, such as albuterol, is appropriate for acute symptoms.
Which lipid level would you report to the doctor because it is not normal and it is also a significant change in the client?
- A. Triglycerides: 75 mg/dL
- B. Total cholesterol: 6.5 mmol/L
- C. High-density lipoprotein (HDL): 60 mg/dL
- D. Low-density lipoprotein (LDL): 955 mg/dL
Correct Answer: D
Rationale: LDL of 955 mg/dL is extremely high (normal <130 mg/dL), indicating a significant risk for cardiovascular disease and requiring immediate reporting.
A primiparous client at 48 hours postpartum is to be given medroxyprogesterone acetate (Depo-Provera) before discharge. Which of the following should the nurse include in the teaching plan before administering this medication?
- A. There is an increased risk of ovarian cancer with use of this drug.
- B. Amenorrhea is common during the first 6 months.
- C. Heavy menstrual bleeding may occur.
- D. The client may experience periods of increased energy.
Correct Answer: B
Rationale: Amenorrhea is a common side effect of Depo-Provera, especially in the first 6 months, and should be included in client teaching. The other options are incorrect.