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A client with HIV has been prescribed anti viral medications. What instructions related to administration of medications should the nurse give such a client?
- A. Comply with the timing of antiviral medication around meals
- B. Avoid exposure to harsh sunlight for about 2hrs after taking the medication
- C. Have the medications with plenty of fruit juice
- D. Have an increased dose of the medications if the symptoms worsen
Correct Answer: A
Rationale: Correct Answer: A
Rationale:
1. Timing: Antiviral medications should be taken as prescribed to maintain consistent drug levels in the body.
2. Around meals: Taking medications with or without food can affect absorption, so timing around meals helps with consistency.
3. Compliance: Following the timing instructions increases medication effectiveness and reduces the risk of drug resistance.
Other Choices:
B) Avoiding harsh sunlight: Not directly related to medication administration; may be a precaution for other reasons.
C) Having medications with fruit juice: This is not a standard instruction for antiviral medications; may not be suitable for all medications.
D) Increasing dose for worsening symptoms: This is dangerous and should only be done under healthcare provider supervision; self-adjusting medication doses can be harmful.
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The nurse recognizes that the major early problem for Mr. Gabatan will be:
- A. Bladder control
- B. Quadriceps setting
- C. Client education
- D. Use of aids for ambulation
Correct Answer: B
Rationale: The correct answer is B: Quadriceps setting. After surgery, quadriceps setting exercises are crucial for preventing muscle atrophy and maintaining joint mobility. Bladder control (A) is important but typically not the major early problem. Client education (C) and use of aids for ambulation (D) are important aspects of care but not the primary concern immediately post-surgery. Quadriceps setting helps prevent complications and promote early mobility.
. Which of the following laboratory test results would the nurse expect to find in a client diagnosed with Hashimoto’s thyroiditis?
- A. Thyroxine (T4), 22 ug/dl; triiodothyronine (T3), 320ng/dl; thyroid-stimulating hormone
- B. (TSH) undetectable
- C. T4, 22 ug/dl; T3, 200 ng/dl; TSH 0.1 uIU/ml
- D. T4, 2 ug/dl; t3, 35 ng/dl; TSH 45 uIU/ml
Correct Answer: C
Rationale: Rationale for correct answer C: In Hashimoto's thyroiditis, an autoimmune disorder causing hypothyroidism, we expect to see normal to elevated TSH levels due to the pituitary gland stimulating the thyroid to produce more hormones. T4 and T3 levels may be within normal range or slightly decreased. Choice C reflects this pattern with T4 at 22 ug/dl, T3 at 200 ng/dl, and TSH at 0.1 uIU/ml.
Summary of why other choices are incorrect:
- Choice A: T4 and T3 levels are higher than expected in Hashimoto's thyroiditis, and TSH should be elevated, not stated as normal.
- Choice B: An undetectable TSH level is typically seen in hyperthyroidism, not hypothyroidism like Hashimoto's.
- Choice D: T4 and T3 levels are significantly lower than expected, and TSH is much higher than typically seen in Hashimoto's
Hypernatremia is associated with a:
- A. Serum osmolality of 245mOsm/kg
- B. Urine specific gravity below 1.003
- C. Serum sodium of 150mEq/L
- D. Combination of all of the above
Correct Answer: D
Rationale: Step 1: Hypernatremia is defined by elevated serum sodium levels (>145mEq/L).
Step 2: Serum osmolality of 245mOsm/kg is high, consistent with hypernatremia.
Step 3: Urine specific gravity below 1.003 indicates dilute urine, a common finding in hypernatremia.
Step 4: The combination of elevated serum sodium, high serum osmolality, and low urine specific gravity confirms hypernatremia.
Summary:
A: Incorrect, as high serum osmolality (not 245mOsm/kg) is associated with hypernatremia.
B: Incorrect, as low urine specific gravity (not below 1.003) is seen in hypernatremia.
C: Incorrect, as serum sodium needs to be >145mEq/L to indicate hypernatremia.
During the physical assessment, the nurse recalls that the areas most frequently affected by multiple sclerosis are the:
- A. Lateral, 3rd and 4th ventricles
- B. Pons medulla and cerebral peduncles
- C. Optic nerve and chiasm
- D. Above areas
Correct Answer: C
Rationale: Rationale for Choice C (Correct Answer):
1. Multiple sclerosis (MS) commonly affects the optic nerve and chiasm.
2. MS is characterized by demyelination of nerves, leading to visual disturbances.
3. Optic nerve involvement results in vision problems, such as blurred vision.
4. Chiasm involvement can cause visual field deficits and color perception changes.
Summary of Other Choices:
A: Lateral, 3rd, and 4th ventricles - Incorrect. MS primarily affects the central nervous system, not ventricles.
B: Pons, medulla, and cerebral peduncles - Incorrect. While these areas are part of the brainstem, they are not commonly affected in MS.
D: Above areas - Incorrect. This choice is vague and does not specify any specific areas affected by MS.
Which of the ff is a reason for providing early discharge instructions and making arrangements for home care for clients undergoing mastectomy?
- A. The adverse effect of mastectomy are immediate
- B. The wound of the surgery is highly contagious and the client should exercise isolation precautions immediately after the procedure
- C. Most clients are not hospitalized long after a mastectomy
- D. The suicidal tendencies in the women undergoing a mastectomy are high
Correct Answer: C
Rationale: Step 1: Most clients are not hospitalized long after a mastectomy - Correct. This is because mastectomy is often performed as an outpatient procedure, and clients are discharged home shortly after surgery.
Step 2: The adverse effects of mastectomy are not immediate - Incorrect. Adverse effects may occur post-surgery, but early discharge is not solely due to immediate adverse effects.
Step 3: The wound of the surgery is not highly contagious - Incorrect. Mastectomy wounds are not contagious, and isolation precautions are not necessary.
Step 4: Suicidal tendencies in women undergoing mastectomy are not high - Incorrect. While emotional support is crucial, early discharge is not primarily due to suicidal tendencies.
Summary: Choice C is correct because mastectomy clients are typically not hospitalized long, making early discharge instructions and home care arrangements necessary. Choices A, B, and D are incorrect as they do not directly relate to the primary reason for early discharge and home care planning.