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A client with labyrinthitis is prescribed antibiotics. What instruction is most important for the nurse to include?
- A. Immediately report headache or stiff neck.
- B. Keep all follow-up appointments.
- C. Take the antibiotics with a full glass of water.
- D. Take the antibiotic on an empty stomach.
Correct Answer: A
Rationale: Meningitis is a complication of labyrinthitis. The client should be taught to take all antibiotics as prescribed and to report manifestations of meningitis such as fever, headache, or stiff neck. Keeping follow-up appointments is important for all clients. Without knowing what antibiotic was prescribed, the nurse cannot instruct the client on how to take it.
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A client has Ménière's disease with frequent attacks. About what drugs does the nurse plan to teach the client? (Select all that apply.)
- A. Broad-spectrum antibiotics
- B. Chlorpromazine hydrochloride (Thorazine)
- C. Diphenhydramine (Benadryl)
- D. Meclizine (Antivert)
- E. Nonsteroidal anti-inflammatory drug (NSAID)
Correct Answer: B,C,D
Rationale: Drugs such as chlorpromazine, diphenhydramine, and meclizine can all be used to treat Ménière's disease. Antibiotics and NSAIDs are not used.
A nurse is teaching a community group about noise-induced hearing loss. Which client who does not use ear protection should the nurse refer to an audiologist as the priority?
- A. Client with an hour car commute on the freeway each day.
- B. Client who rides a motorcycle daily.
- C. Client who sat in the back at a rock concert recently.
- D. Client who uses a chainsaw for 6 to 7 hours a day.
Correct Answer: D
Rationale: A chainsaw becomes dangerous to hearing after 2 hours of exposure without hearing protection. This client needs to be referred as the priority. Normal car traffic is safe for longer than 2 hours. Motorcycle noise is safe for about 8 hours. The safe exposure time for a front-row rock concert seat is 3 minutes, but this client was in the back, and so had less exposure. In addition, a one-time exposure is less damaging than chronic exposure.
A client with Ménière's disease is in the hospital when the client has an attack of this disorder. What action by the nurse takes priority?
- A. Assess vital signs every 15 minutes.
- B. Dim or turn off lights in the client's room.
- C. Place the client in bed with the upper siderails up.
- D. Provide a cool, wet cloth for the client's face.
Correct Answer: C
Rationale: Clients with Ménière's disease can have vertigo so severe that they can fall. The nurse should assist the client into bed and raise the upper siderails to prevent falls due to the intense whirling feeling. The other actions are not warranted for clients with Ménière's disease.
A client hospitalized for a wound infection has a blood urea nitrogen of 45 mg/dL and creatinine of 4.2 mg/dL. What action by the nurse is most appropriate?
- A. Assess for signs of dehydration.
- B. Review the client's medication list.
- C. Monitor for signs of hearing loss.
- D. Consult with the healthcare provider.
Correct Answer: D
Rationale: Elevated blood urea nitrogen (BUN) and creatinine levels suggest renal impairment, which can affect drug metabolism and increase the risk of ototoxicity from certain medications. Consulting with the healthcare provider is the most appropriate action to ensure safe care. The other options may be relevant but are not the priority.
The student nurse is performing a Weber tuning fork test. What technique is most appropriate?
- A. Holding the vibrating tuning fork 10 to 12 inches from the clients ear
- B. Placing the vibrating fork in the middle of the clients head
- C. Placing the vibrating fork in the middle of the clients head
- D. Tapping the vibrating tuning fork against the bridge of the nose
Correct Answer: B
Rationale: The Weber tuning fork test involves placing the vibrating tuning fork in the middle of the client's head and asking in which ear the client hears the vibrations loudest. The other techniques are incorrect.