Nokea
A client with active pulmonary tuberculosis is prescribed 4-drug therapy with ethambutol. The nurse reinforces previous teaching to notify the health care provider immediately if which adverse effect associated with ethambutol occurs?
- A. Blurred vision
- B. Dark-colored urine
- C. Difficulty hearing
- D. Yellow skin
Correct Answer: A
Rationale: Ethambutol can cause optic neuritis, leading to blurred vision (A), a serious side effect requiring immediate reporting. Dark urine (B), hearing loss (C), and jaundice (D) are associated with other TB drugs (e.g., rifampin, isoniazid).
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The nurse has reinforced nutritional teaching on a client with gout who is placed on a low-purine diet. Which selection by the client would indicate a need for further teaching?
- A. Broccoli
- B. An orange
- C. Chocolate cake
- D. Fish
Correct Answer: D
Rationale: Fish should be avoided on a low-purine diet. Other foods to avoid include poultry, liver, lobster, oysters, peas, spinach, and oatmeal. Answers A, B, and C are all foods included on a low-purine diet, which makes them incorrect.
Which of the following indicates that the client taking an anticoagulant needs further teaching?
- A. The client states that he will report bruising
- B. The client states that he eats green, leafy vegetables at least three times weekly
- C. The client states that he will return to the doctor's office for scheduled lab work
- D. The client states that his insulin dose might have to be adjusted while he is taking an anticoagulant
Correct Answer: B
Rationale: Green, leafy vegetables are high in vitamin K, which can counteract anticoagulants like warfarin, so consistent intake or dietary counseling is needed.
The nurse is caring for a client with COPD who becomes dyspneic. The nurse should
- A. instruct the client to breathe into a paper bag
- B. place the client in a high Fowler's position
- C. assist the client with pursed lip breathing
- D. administer oxygen at 6L/minute via nasal cannula
Correct Answer: C
Rationale: Use pursed-lip breathing during periods of dyspnea to control rate and depth of respiration and improve respiratory muscle coordination.
A patient has recently been prescribed Lidocaine Hydrochloride. Which of the following symptoms may occur with over dosage?
- A. Memory loss and lack of appetite
- B. Confusion and fatigue
- C. Heightened reflexes
- D. Tinnitus and spasticity
Correct Answer: B
Rationale: Lidocaine Hydrochloride can cause fatigue and confusion if an over dosage occurs.
In assessing a post partum client, the nurse palpates a firm fundus and observes a constant trickle of bright red blood from the vagina. What is the most likely cause of these findings?
- A. Uterine atony
- B. Genital lacerations
- C. Retained placenta
- D. Clotting disorder
Correct Answer: B
Rationale: Genital lacerations. Continuous bleeding in the absence of a boggy fundus indicates undetected genital tract lacerations.