Nokea
A client with allergic rhinitis is prescribed loratadine (Claritin). On a follow-up visit, the client tells the nurse, "I take one 10-mg of Claritin with a glass of water two times daily". The nurse concludes that the client requires additional teaching about this medication because:
- A. Loratadine isn't available in 10mg tablets
- B. Loratadine should be taken on an empty stomach
- C. Loratadine should be taken once daily for allergenic rhinitis
- D. Claritin isn't the trade name for loratadine
Correct Answer: C
Rationale: Loratadine (Claritin) is typically taken once daily for allergic rhinitis. Taking it two times daily as stated by the client is unnecessary and indicates a lack of understanding about the appropriate dosing schedule for this medication. Claritin is indeed the trade name for loratadine, and it is available in 10mg tablets, but the issue here is the incorrect dosing frequency.
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You are examining a 12-year-old female adolescent with a small nevus in the thigh; the mother is concerned regarding the future development of melanoma. All the following findings raise suspicion of melanoma EXCEPT
- A. enlarging nevus
- B. changing colors
- C. irregular margins
- D. easily bleeds
Correct Answer: E
Rationale: Spitz nevus is a benign mimic of melanoma and does not raise suspicion.
The nurse closely monitors the temperature of a child with minimal change nephrotic syndrome. The purpose of this assessment is to detect an early sign of which possible complication?
- A. Infection
- B. Hypertension
- C. Encephalopathy
- D. Edema
Correct Answer: A
Rationale: In a child with minimal change nephrotic syndrome, the nurse closely monitors the temperature to detect an early sign of infection. Children with nephrotic syndrome are more susceptible to infections due to loss of immunoglobulins in the urine, decreased serum complement levels, and altered immune function. Monitoring the temperature is important to identify any signs of infection early, as prompt treatment is crucial in preventing complications such as sepsis.
You are evaluating a 2-year-old boy with multiple bruises. Physical examination is unremarkable apart from multiple bruising areas. Lab investigations including coagulation profile are normal. Of the following, bruises that are LEAST likely suggestive of physical abuse is
- A. bruises over the neck
- B. looped extension cord marks on the body
- C. bruises over bony prominences
- D. bruising of the torso
Correct Answer: C
Rationale: Bruises over bony prominences are common in toddlers due to falls and rough play, whereas bruises in unusual locations like the neck or torso are more suspicious for abuse.
Parent guidelines for relieving colic in an infant include:
- A. avoiding touching abdomen.
- B. avoiding using a pacifier.
- C. changing infant's position frequently.
- D. placing infant where family cannot hear the crying.
Correct Answer: C
Rationale: Parent guidelines for relieving colic in an infant include changing the infant's position frequently. Colic is a common condition in infants characterized by prolonged periods of crying and fussiness. Changing the infant's position frequently, such as holding them upright or on their stomach, can help alleviate discomfort and aid in releasing trapped gas, which may contribute to colic symptoms. It is recommended to try different positions to see what works best for the individual baby to provide relief from colic.
Which is a clinical manifestation of the systemic venous congestion that can occur with heart failure?
- A. Tachypnea
- B. Tachycardia
- C. Peripheral edema
- D. Pale, cool extremities
Correct Answer: C
Rationale: Peripheral edema is a common clinical manifestation of systemic venous congestion that can occur with heart failure. In heart failure, the heart is unable to pump effectively, leading to a backup of blood in the veins. This increased pressure in the veins causes fluid to leak out into the surrounding tissues, resulting in swelling or edema, most commonly in the lower extremities. Tachypnea (rapid breathing) and tachycardia (fast heart rate) are more associated with the compensatory mechanisms of the body to try to maintain cardiac output and oxygenation. Pale, cool extremities are more indicative of poor peripheral perfusion, which can occur with severe heart failure but are not the typical manifestations of systemic venous congestion.