Nokea
A client with asthma has been prescribed beclomethasone (Beclovent) via metered-dose inhaler. To determine if the client has been rinsing the mouth after each use of the inhaler, the nurse should inspect the client's mouth for:
- A. Gingival hyperplasia.
- B. Oral candidiasis.
- C. Ulceration.
- D. Dental caries.
Correct Answer: B
Rationale: Beclomethasone, an inhaled corticosteroid, can cause oral candidiasis (thrush) if the mouth is not rinsed after use, as residual medication promotes fungal growth.
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The nurse is assessing teenaged girls at a well child clinic. The nurse should describe the girl shown in the figure as having:
- A. Normal posture
- B. Kyphosis
- C. Scoliosis
- D. Lordosis
Correct Answer: C
Rationale: Scoliosis is characterized by a lateral curvature of the spine, which may be observed in a teenager. Kyphosis involves forward curvature, lordosis involves inward lumbar curvature, and normal posture lacks these abnormalities.
When quinidine gluconate is prescribed for a client the nurse reviews the client's medical record. Which condition is a contraindication in the use of this medication?
- A. Asthma
- B. Infection
- C. Muscle weakness
- D. Complete atrioventricular (AV) block
Correct Answer: D
Rationale: Quinidine gluconate is an antidysrhythmic medication used as prophylactic therapy to maintain normal sinus rhythm after conversion of atrial fibrillation and/or atrial flutter. It is contraindicated in complete AV block, intraventricular conduction defects, abnormal impulses and rhythms caused by escape mechanisms, and myasthenia gravis. It is used with caution in clients with preexisting asthma, muscle weakness, infection with fever, and hepatic or renal insufficiency.
A client with a history of chronic obstructive pulmonary disease (COPD) is prescribed theophylline. The nurse should monitor the client for which of the following adverse effects?
- A. Tachycardia.
- B. Hypoglycemia.
- C. Bradycardia.
- D. Weight loss.
Correct Answer: A
Rationale: Theophylline can cause tachycardia due to its stimulant effects.
A client with a history of depression is prescribed bupropion (Wellbutrin). The nurse should instruct the client to report which of the following side effects immediately?
- A. Mild headache.
- B. Seizures.
- C. Nausea.
- D. Fatigue.
Correct Answer: B
Rationale: Bupropion lowers the seizure threshold, and seizures are a serious side effect requiring immediate reporting.
The nurse is caring for a client with a history of deep vein thrombosis (DVT). Which of the following laboratory values should the nurse monitor?
- A. Activated partial thromboplastin time (aPTT).
- B. Prothrombin time (PT).
- C. International normalized ratio (INR).
- D. D-dimer.
Correct Answer: A, D
Rationale: aPTT monitors heparin therapy, and D-dimer indicates clot presence in DVT.