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A nurse is assisting with the admission of a client who has varicella zoster. Which of the following interventions should the nurse plan to implement?
- A. Administer aspirin if the client develops a fever.
- B. Initiate contact precautions for the client.
- C. Assign the client to a negative-pressure airflow room.
- D. Have visitors remain at least 0.91 m (3 feet. away from the client.
Correct Answer: C
Rationale: Varicella requires airborne precautions, including a negative-pressure room, to prevent spread. Aspirin risks Reye's syndrome, contact precautions alone are insufficient, and distance doesn't replace airborne measures.
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A nurse is reinforcing teaching with a client who has a new prescription for citalopram. Which of the following statements should the nurse include?
- A. You should take this medication at bedtime.
- B. You might experience dry mouth while taking this medication.
- C. You need to avoid tyramine-rich foods while taking this medication.
- D. You can expect symptom improvement within 48 hours.
Correct Answer: B
Rationale: Citalopram can cause dry mouth, a common side effect. Timing is flexible, tyramine isn't a concern, and effects take weeks.
A nurse is reinforcing teaching with a client who has a new prescription for gabapentin. Which of the following statements by the client indicates an understanding of the teaching?
- A. I should take this medication with a high-fat meal.
- B. I might feel sleepy while taking this medication.
- C. I need to avoid sunlight while taking this medication.
- D. I can stop taking this medication as soon as my pain goes away.
Correct Answer: B
Rationale: Gabapentin can cause drowsiness, reflecting understanding. Food intake is flexible, sunlight isn't a concern, and stopping needs tapering.
A nurse is caring for a client who is receiving IV vancomycin. Which of the following actions should the nurse take?
- A. Infuse the medication over 30 min.
- B. Monitor the client for tinnitus.
- C. Administer the medication with an antihistamine.
- D. Check the client's blood pressure every 4 hr.
Correct Answer: B
Rationale: Vancomycin can cause ototoxicity, so monitoring for tinnitus is essential. It's infused over 60-90 minutes, antihistamines aren't needed, and blood pressure checks aren't specific to vancomycin.
A nurse is reinforcing teaching with a client who has a new prescription for bupropion. Which of the following statements should the nurse include?
- A. Take this medication at bedtime.
- B. You might have dry mouth while taking this medication.
- C. You need to avoid tyramine-rich foods.
- D. You can expect immediate mood improvement.
Correct Answer: B
Rationale: Bupropion can cause dry mouth, a side effect to monitor. It's taken in the morning, tyramine isn't a concern, and mood improvement takes weeks.
A nurse is caring for a client who is receiving continuous enteral feeding. Which of the following actions should the nurse take?
- A. Check gastric residual volume every 4 hr.
- B. Flush the tube with water every 12 hr.
- C. Position the client supine during feeding.
- D. Change the feeding bag every 48 hr.
Correct Answer: A
Rationale: Checking residual volume every 4 hours assesses tolerance, preventing aspiration. Flushing is more frequent, supine positioning risks aspiration, and bags change every 24 hours.