Nokea
A client with a knee injury is scheduled for an MRI examination. The nurse explains the test to the client. Which finding in the client would make the client ineligible for this type of exam?
- A. Presence of a metal plate in the leg from an old fracture
- B. Presence of a ceramic artificial hip
- C. A history of asthma attacks
- D. Allergy to injected dye
Correct Answer: A
Rationale: A metal plate is a contraindication for MRI due to magnetic interference, making the client ineligible.
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The nurse is reviewing teaching with the parents of a child who has tinea capitis (ringworm of the scalp) and is newly prescribed griseofulvin oral suspension and 1% selenium sulfide shampoo. Which statement by the child's parent requires the nurse to intervene?
- A. I will discontinue the griseofulvin once the ringworm stops itching and the scales go away.
- B. I will give the griseofulvin suspension to my child after consumption of high-fat food, like ice cream.
- C. I will monitor my child for increased sensitivity to sunlight while taking griseofulvin.
- D. I will wash my child's scalp a few times per week with the medicated shampoo.
Correct Answer: A
Rationale: Griseofulvin requires a full course (6-8 weeks) to eradicate tinea capitis, even if symptoms resolve, to prevent recurrence. High-fat foods enhance absorption, photosensitivity is a side effect, and shampoo use a few times weekly is appropriate.
The nurse in an ambulatory care center is reinforcing teaching to a client with a diagnosis of persistent depressive disorder (dysthymia) about the appropriate use of bupropion hydrochloride sustained release. What statement by the client indicates a need for further teaching?
- A. If I have a sudden change in my mood, I should call my physician immediately.
- B. If I have trouble swallowing the tablet, I can cut it in half.
- C. If I miss a dose, I should not double the next dose to catch up.
- D. It may take several weeks before I get better.
Correct Answer: B
Rationale: Bupropion sustained-release tablets must not be cut, as this disrupts the controlled-release mechanism, risking side effects. Other statements are correct: mood changes require reporting, missed doses shouldn't be doubled, and therapeutic effects take weeks.
The nurse is reviewing the medical record for an adolescent client with major depressive disorder. Which of the following findings would be consistent with the condition? Select all that apply.
- A. often sleeps during class or after-school activities
- B. has received disciplinary action at school due to absenteeism and angry outbursts
- C. has unintentionally lost 8 lb (3.6 kg) over the past 3 weeks
- D. abruptly quit playing sports despite receiving previous athletic awards and trophies
- E. voices concern about the appearance of acne on the face
Correct Answer: A,B,C,D
Rationale: Excessive sleep, irritability (outbursts), weight loss, and loss of interest in activities (quitting sports) are hallmarks of depression. Acne concern is typical adolescent behavior, not specific to depression.
After assisting a client with a lower gastrointestinal bleed back to bed, the nurse finds approximately 600 mL of frank red blood in the toilet. The client is pale and diaphoretic and reports dizziness. Which action should the nurse perform first?
- A. Document the output and vital signs
- B. Draw blood for hemoglobin and hematocrit
- C. Lower the head of the bed
- D. Notify the registered nurse
Correct Answer: C
Rationale: Significant bleeding (600 mL), pallor, diaphoresis, and dizziness suggest hypovolemia. Lowering the head of the bed improves cerebral perfusion, stabilizing the client. Notification, labs, and documentation follow stabilization.
An adult is taking phenazopyridine hydrochloride (Pyridium) 200 mg PO tid after meals. Which comment by the client indicates a lack of understanding about the medication?
- A. If I take my medications after meals, I avoid upsetting my stomach.'
- B. I am concerned that my urine is bright orange.'
- C. I do not have as great an urge to urinate since I have been on Pyridium.'
- D. I have to let my doctor know if my skin or eyes turn yellow.'
Correct Answer: B
Rationale: Bright orange urine is a normal effect of Pyridium, so concern about it indicates a lack of understanding of the medication's side effects.