Nokea
A mother brings her 6-month-old child to the clinic for a wellness checkup. The nurse anticipates that the health care provider will order which vaccinations for this client?
- A. DTaP and MMR
- B. Hib and varicella
- C. hepatitis B and DTaP
- D. hepatitis A and MMR
Correct Answer: C
Rationale: At 6 months, hepatitis B and DTaP are scheduled. MMR, varicella, and hepatitis A are given later (12-15 months).
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The nurse teaches a client with hypertension to recognize the signs/symptoms that may occur during periods of elevated blood pressure. The nurse determines that the client needs additional teaching if the client states that which sign/symptom is associated with this condition?
- A. Epistaxis
- B. Dizziness
- C. Blurred vision
- D. A feeling of fullness in the head
Correct Answer: D
Rationale: A feeling of fullness in the head is more likely associated with a sinus condition than hypertension. Cerebrovascular symptoms of hypertension include early morning headaches, occipital headaches, epistaxis, dizziness, blurred vision, lightheadedness, and vertigo. The client should be aware of these signs/symptoms and report them if they occur. The client should also be taught to self-monitor the blood pressure.
Allopurinol has been prescribed for a client to treat gouty arthritis. The nurse teaches the client to anticipate which prescription if an acute attack occurs?
- A. Doubling the dose of the allopurinol
- B. Stopping the allopurinol and taking acetylsalicylic acid (aspirin)
- C. Stopping the allopurinol and taking a nonsteroidal anti-inflammatory drug
- D. Adding colchicine or a nonsteroidal anti-inflammatory drug to the treatment plan
Correct Answer: D
Rationale: Allopurinol helps prevent an attack of gouty arthritis, but it does not relieve the pain. Therefore, another medication such as colchicine or a nonsteroidal anti-inflammatory drug must be added if an acute attack occurs. Because acute attacks may occur more frequently early during the course of therapy with allopurinol, some health care providers recommend taking the two products concurrently during the first 3 to 6 months.
A client being discharged from the hospital will be taking warfarin sodium at home on a daily basis. The nurse has provided instructions to the client about the medication and determines that further teaching is needed if the client makes which statement?
- A. I need to have a prothrombin time checked in 2 weeks.
- B. This medicine thins my blood and allows me to clot more slowly.
- C. I need to increase the intake of foods high in vitamin K in my diet.
- D. I need to report any increased bleeding or bruising to my doctor.
Correct Answer: C
Rationale: Warfarin sodium is an oral anticoagulant that is used mainly to prevent thrombotic events, such as thrombophlebitis, pulmonary embolism, and embolism formation caused by atrial fibrillation or other disorders. Oral anticoagulants prolong the clotting time and are monitored by the prothrombin time and the international normalized ratio (INR). Client education should include signs and symptoms of adverse effects and dietary limitations such as limiting foods high in vitamin K (e.g., leafy green vegetables, liver, cheese, egg yolks) as prescribed because these increase clotting times.
The labor and delivery nurse expects which clients to be at high risk for amniotic fluid embolus (AFE)? Select all that apply.
- A. a 27-year-old client with preeclampsia
- B. a healthy 23-year-old anticipating a vaginal delivery
- C. a 42-year-old expecting her second child via cesarean section
- D. a 32-year-old client with diabetes anticipating induced labor
Correct Answer: A,C,D
Rationale: Preeclampsia, cesarean section, and induced labor increase AFE risk due to uterine trauma or hyperstimulation. A healthy vaginal delivery has lower risk.
The nurse has completed instructions with a client with atrial fibrillation who will be taking warfarin sodium indefinitely. Which statement by the client indicates the need for further teaching?
- A. I need to use a soft toothbrush.
- B. I need to avoid drinking alcohol while taking this medication.
- C. I can continue to take my NSAIDs as previously prescribed.
- D. I should carry identification regarding the medication being taken.
Correct Answer: C
Rationale: Warfarin increases bleeding risk, and NSAIDs can exacerbate this, especially causing GI bleeding, so they should be avoided without provider approval. Using a soft toothbrush, avoiding alcohol, and carrying medication identification are correct to prevent bleeding and ensure safety.