Nokea
A nurse has educated a client on isoniazid (INH). What statement by the client indicates teaching has been effective?
- A. I need to take extra vitamin C while on INH.
- B. I should take this medicine with milk or juice.
- C. I should take this medication on an empty stomach.
- D. My contact lenses will be permanently stained.
Correct Answer: C
Rationale: INH needs to be taken on an empty stomach, either 1 hour before or 2 hours after meals. This statement indicates the client understands the correct administration of the medication.
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A nurse in a family practice clinic is preparing discharge instructions for a client reporting facial pain that is worse when bending over, tenderness across the cheeks, and postnasal discharge. What instruction will be most helpful?
- A. Ice packs may help with the facial pain.
- B. Limit fluids to dry out your sinuses.
- C. Try warm, moist heat packs on your face.
- D. We will schedule you for a computed tomography scan this week.
Correct Answer: C
Rationale: This client has rhinosinusitis. Comfort measures for this condition include breathing in warm steam, hot packs, nasal saline irrigation, sleeping with the head elevated, increased fluids, and avoiding cigarette smoke. Warm, moist heat packs are particularly effective for relieving facial pain.
A client in the emergency department is taking rifampin (Rifadin) for tuberculosis. The client reports yellowing of the sclera and skin and bleeding after minor trauma. What laboratory results correlate to this condition? (Select all that apply.)
- A. Blood urea nitrogen (BUN): 19 mg/dL.
- B. International normalized ratio (INR): 6.3.
- C. Prothrombin time: 35 seconds.
- D. Serum sodium: 120 mEq/L.
- E. White blood cell (WBC) count: 72,000/mm³.
Correct Answer: B,C
Rationale: Rifampin can cause liver damage, evidenced by the client's high INR and prothrombin time, which indicate coagulopathy due to liver dysfunction. The BUN, WBC count, and sodium levels are not directly related to this condition.
A client has been diagnosed with an empyema. What interventions should the nurse anticipate providing to this client? (Select all that apply.)
- A. Assisting with chest tube insertion.
- B. Facilitating pleural fluid sampling.
- C. Performing frequent respiratory assessment.
- D. Providing antibiotics as needed.
- E. Suctioning deeply every 4 hours.
Correct Answer: A,B,C,D
Rationale: The client with an empyema is often treated with chest tube insertion, which facilitates obtaining samples of the pleural fluid for analysis and expands the lungs. The nurse should perform frequent respiratory assessments and provide antibiotics as needed. Suctioning is not routinely done deeply to prevent tissue injury.
A nurse is caring for several older clients in the hospital that the nurse identifies as being at high risk for healthcare-associated pneumonia. To reduce this risk, what activity should the nurse delegate to the unlicensed assistive personnel (UAP)?
- A. Encourage between-meal snacks.
- B. Monitor temperature every 4 hours.
- C. Provide oral care every 4 hours.
- D. Report any new onset of cough.
Correct Answer: C
Rationale: Oral colonization by gram-negative bacteria is a risk factor for healthcare-associated pneumonia. Good, frequent oral care can help prevent this from developing and is a task that can be delegated to the UAP.
A nurse is providing pneumonia vaccinations in a community setting. Due to limited finances, the event organizers must limit giving the vaccination to priority groups. What clients would be considered a priority? (Select all that apply.)
- A. 22-year-old client with asthma.
- B. Client who had a cholecystectomy last year.
- C. Client with well-controlled diabetes.
- D. Healthy 72-year-old client.
- E. Client who is taking medication for hypertension.
Correct Answer: A,C,D,E
Rationale: Clients over 65 years of age and any client with a chronic health condition (e.g., asthma, diabetes, hypertension) are considered a priority for a pneumonia vaccination. A cholecystectomy does not qualify as a chronic health condition.