Nokea
A nurse at a family practice clinic receives a call from a client who is prescribed oral contraceptives but forgot to take one dose. The client reports she is in the first week of a 28-day cycle pack. Which of the following instructions should the nurse provide?
- A. Stop taking the pills and switch to a different contraceptive method.
- B. Take a home pregnancy test.
- C. Do not have vaginal intercourse until after your next period.
- D. Take the missed dose now, then continue the medication as ordered.
Correct Answer: D
Rationale: The correct answer is D: Take the missed dose now, then continue the medication as ordered. In the first week of a 28-day cycle pack, missing one pill does not significantly impact contraceptive efficacy. Taking the missed dose as soon as possible and then continuing the medication as prescribed maintains the contraceptive effectiveness. Choice A is incorrect as stopping the pills abruptly can lead to unintended pregnancy. Choice B is unnecessary as missing one pill does not automatically indicate pregnancy. Choice C is not relevant in this context as the client can still take the missed dose and continue with the contraceptive method.
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A nurse is assessing a client who has schizophrenia and has been on long-term treatment with chlorpromazine. He notes the client is experiencing some involuntary movements of the tongue and face. The nurse should suspect the client has developed which of the following adverse effects?
- A. Akathisia
- B. Tardive dyskinesia
- C. Dystonia
Correct Answer: B
Rationale: The correct answer is B: Tardive dyskinesia. Tardive dyskinesia is a common adverse effect of long-term antipsychotic medication use, such as chlorpromazine. It is characterized by involuntary movements of the tongue and face. This condition is often irreversible and can be distressing for the client. Akathisia (choice A) is a different extrapyramidal side effect characterized by restlessness and the urge to move constantly. Dystonia (choice C) is another extrapyramidal side effect that presents as sustained muscle contractions causing abnormal postures. In this case, the symptoms described in the question are more indicative of tardive dyskinesia due to the specific type of involuntary movements observed in the client.
A nurse is preparing to administer fluoxetine 30 mg PO daily to a client. The amount available is fluoxetine 10 mg tablets. How many tablets should the nurse administer per dose? (Round the answer to the nearest whole number. Use a leading zero if it applies. Do not use a trailing zero)
Correct Answer: 3
Rationale: The correct answer is 3 tablets. To achieve a total of 30 mg, the nurse should administer 3 tablets of 10 mg each (10 mg x 3 = 30 mg). Other choices are incorrect because: A) 1 tablet is not enough to reach 30 mg, B) 2 tablets only add up to 20 mg, C) 4 tablets exceed the required dose, D) 5 tablets exceed the required dose, E) 6 tablets exceed the required dose, F) 7 tablets exceed the required dose, G) 8 tablets exceed the required dose.
A nurse is caring for a client who is postoperative following a transurethral resection of the prostate. Which of the following complications is the priority for the nurse to monitor for?
- A. Hemorrhage
- B. Infection
- C. Urinary retention
- D. Pain
Correct Answer: A
Rationale: The correct answer is A: Hemorrhage. Postoperative hemorrhage is a critical complication following a transurethral resection of the prostate due to the rich blood supply in the area. It can lead to hypovolemic shock and requires immediate intervention to prevent further complications. Monitoring for signs of bleeding such as increased heart rate, decreased blood pressure, and decreased urine output is crucial.
B: Infection is an important complication to monitor for but is not as immediately life-threatening as hemorrhage.
C: Urinary retention can occur postoperatively but is not as urgent as hemorrhage.
D: Pain management is important for the client's comfort, but it is not the priority in this situation.
In summary, monitoring for hemorrhage is crucial as it is the most life-threatening complication that requires immediate attention compared to the other options.
A nurse is preparing a client who is to receive chemotherapy for treatment of ovarian cancer. Which of the following actions should the nurse plan to take?
- A. Tell the client to expect dark stools following chemotherapy.
- B. Have the client swish with commercial mouthwash before therapy.
- C. Administer an antiemetic prior to the procedure.
- D. Have the client floss 4 times daily.
Correct Answer: C
Rationale: The correct answer is C: Administer an antiemetic prior to the procedure. This is important because chemotherapy often causes nausea and vomiting. Administering an antiemetic helps prevent or reduce these side effects, promoting client comfort and compliance with treatment. Choice A is incorrect because dark stools are not a common side effect of chemotherapy for ovarian cancer. Choice B is incorrect as using mouthwash before therapy may not be relevant to chemotherapy administration. Choice D is incorrect as flossing frequency is not directly related to chemotherapy treatment.
A nurse is instructing a female client on obtaining a midstream urine specimen. Which of the following statements by the client indicates an understanding of the teaching?
- A. I will wipe from the back to front with the cleaning cloth.
- B. I need to urinate a small amount in the toilet before collecting the sample.
- C. I should let the urine cool to room temperature before sending it to the lab.
- D. I should not collect a urine sample when I am menstruating.
Correct Answer: B
Rationale: Correct Answer: B - "I need to urinate a small amount in the toilet before collecting the sample."
Rationale:
1. This statement indicates the client understands the importance of collecting a midstream urine sample.
2. By urinating a small amount first, the initial stream clears any bacteria present in the urethra, ensuring a more accurate sample.
3. Collecting a midstream sample helps to avoid contamination from the surrounding genital area.
4. This method is essential for accurate urinalysis results and diagnosis of potential urinary tract infections.
Incorrect Choices:
A: Incorrect - Wiping from back to front can introduce bacteria from the anal region into the urethra, leading to contamination.
C: Incorrect - Cooling the urine to room temperature is not necessary for a midstream urine sample collection.
D: Incorrect - Menstruation does not interfere with the accuracy of a midstream urine sample collection.