Nokea
A client with rheumatoid arthritis expresses not feeling the need to take medication any longer since being in remission without symptoms. What is the best response by the nurse?
- A. If you don't take your medication, you will become very ill.'
- B. Be sure to let the physician know after you stop your medications.'
- C. It is important that you continue to take your medication to avoid an acute exacerbation.'
- D. As long as you are not having symptoms, you can take a medication vacation.'
Correct Answer: C
Rationale: Even with remission, most people must continue taking prescribed medications to avoid another acute exacerbation. The client should be encouraged to maintain the therapeutic regimen in order to avoid an exacerbation and prolong the period of remission as long as possible. The client should notify the physician if considering discontinuation of the medication. The nurse is not at liberty to allow the client to discontinue medication use. Stating that discontinuing the medication will cause the client to become ill does not provide an adequate explanation to the client.
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A client comes to the clinic and reports having had a mild case of the flu a couple of months ago and not having felt well since. The client expresses feeling fatigued that gets worse after any physical activity and having a recurrent sore throat and joint pain. What does the nurse recognize these symptoms may indicate?
- A. Chronic fatigue syndrome
- B. Rheumatoid arthritis
- C. Ulcerative colitis
- D. Recurrent flu
Correct Answer: A
Rationale: Many clients with CFS report having had a recent illness with flulike symptoms or an upper respiratory infection. Despite having been uncomfortable, most clients do not describe their initial symptoms as being extraordinarily severe. Severe, ongoing fatigue lasts for at least 6 months without any explanation. Even though the fatigue is constant, it worsens after physical activity. The fatigue is so debilitating that it usually interferes with a person's ability to work in or outside the home. Rheumatoid arthritis and ulcerative colitis are autoimmune disorders with symptoms that are more specific than CFS and can be diagnosed with diagnostic testing and laboratory studies. The symptoms that the client is having are not characteristic of the flu.
The nurse is instructing a client with chronic fatigue syndrome about what type of dietary sources are the best to eat to supply eicosapentaenoic acid (EPA). What statement by the client demonstrates the instruction is understood?
- A. I will eat shrimp at least twice a week.'
- B. I love crab cakes and will be sure to make them once a week.'
- C. Fresh salmon is one of my favorites, and I will eat it twice a week.'
- D. Lobster is expensive, but I will eat it once a week.'
Correct Answer: C
Rationale: Fish oils provide the only dietary source of EPA. Fatty fish, such as mackerel, sardines, herring, salmon, and tuna, are the best sources. Shellfish, such as shrimp, crab, and lobsters do not offer the dietary source of EPA that is required.
A client calls the clinic and asks the nurse if using oxymetazoline nasal spray would be all right to relieve nasal congestion caused by seasonal allergies. What instructions should the nurse provide to the client to avoid complications?
- A. Report white patches in the mouth because the medication can cause a fungal infection.
- B. Do not overuse the medication as rebound congestion can occur.
- C. Taper the dose when discontinuing the medication.
- D. Do not operate machinery or drive while using the medication.
Correct Answer: B
Rationale: Overusing oxymetazoline nasal spray can cause rebound congestion. The medication does not cause fungal infection. Corticosteroids should be tapered, but it is not necessary to taper oxymetazoline. Oxymetazoline does not cause sleepiness so the client can operate machinery or drive.
A client comes to the clinic and reports having 'broken out in hives and itching since eating strawberries this morning.' The client states never having had problems with strawberries before. What is the best response by the nurse?
- A. It is probably not the strawberries that you are having an allergy to if you have eaten them before.'
- B. It is possible to develop an allergic reaction to something you have had prior exposure to previously.'
- C. Are you sure that you haven't had an allergic reaction before; this doesn't seem possible.'
- D. We will probably be admitting you to the hospital; this could cause respiratory arrest.'
Correct Answer: B
Rationale: Allergies can occur at any age, and the pattern of allergic response can vary in the same person at different points in life. For example, a person may suddenly develop an allergic reaction to a substance such as latex, despite having had multiple prior contacts with latex and no past problems. Although an allergic reaction may cause laryngeal swelling, this client does not exhibit any of the signs and symptoms of respiratory distress that would lead to respiratory arrest.
A client presents to the clinic with reports of itching and hives after taking an aspirin this morning. What medication does the nurse anticipate administering that blocks histamine receptors?
- A. Diphenhydramine
- B. Flunisolide
- C. Beclomethasone dipropionate
- D. Pseudoephedrine hydrochloride
Correct Answer: A
Rationale: Diphenhydramine is an antihistamine used for allergic reactions. Flunisolide is a nasal decongestant agent and is used locally to the nasal mucosa. Beclomethasone dipropionate is a nasal steroid spray and inhalant. Pseudoephedrine hydrochloride only constricts nasal membranes.