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A nurse is discharging a client who is receiving lithium for treatment of a bipolar disorder. It is most important for the nurse to reinforce which instruction to the client?
- A. Avoid a high-potassium diet
- B. Exercise regularly and maintain a high-fiber diet
- C. Maintain oral hygiene
- D. Report excessive urination and increased thirst
Correct Answer: D
Rationale: Lithium can cause polyuria and polydipsia due to its effect on renal function. These symptoms may indicate lithium toxicity or diabetes insipidus, which require immediate medical attention.
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An infant with Tetralogy of Fallot is discharged with a prescription for Lanoxin (digoxin) elixir. The nurse should instruct the mother to:
- A. Administer the medication using a nipple
- B. Administer the medication using the calibrated dropper in the bottle
- C. Administer the medication using a plastic baby spoon
- D. Administer the medication in a baby bottle with 1 ounce of water
Correct Answer: B
Rationale: The calibrated dropper ensures accurate dosing of digoxin, which is critical due to its narrow therapeutic range. Other methods risk incorrect dosing.
The mother of a 1-week-old infant says to the nurse, 'When will that ugly black cord thing come off?' How should the nurse reply?
- A. Are you wiping it with alcohol each time you change the baby's diaper?'
- B. It usually comes off in 10 days to three weeks.'
- C. It sounds as if it bothers you. Would you like to talk about it?'
- D. It should be off by now. I'll have the doctor check to be sure there is no problem.'
Correct Answer: B
Rationale: The umbilical cord typically detaches in 10 days to 3 weeks, providing accurate information. Other responses are irrelevant or incorrect.
Which of the following symptoms is associated with exacerbation of multiple sclerosis?
- A. Anorexia
- B. Seizures
- C. Diplopia
- D. Insomnia
Correct Answer: C
Rationale: Diplopia (double vision) is a common symptom during multiple sclerosis exacerbations, resulting from demyelination affecting the optic nerves or brainstem.
The nurse is teaching the parent of a 6-year-old client about sleep. Which of the following information should the nurse include? Select all that apply.
- A. Your child should sleep 9 to 12 hours every night.
- B. As your child grows, the hours of required sleep increase.
- C. Encourage active play before bedtime to promote restful sleep.
- D. Avoid giving your child large amounts of liquid after dinnertime.
- E. It is important to establish and maintain a regular bedtime routine.
Correct Answer: A,D,E
Rationale: Children aged 6 need 9-11 hours of sleep, limited liquids prevent bedwetting, and routines promote sleep. Sleep needs decrease with age, and active play close to bedtime may disrupt sleep.
The nurse is monitoring a 12-month-old diagnosed with intussusception. Which findings should the nurse expect? Select all that apply.
- A. Palpable olive-shaped mass in epigastrium
- B. Palpable sausage-shaped mass in upper right quadrant
- C. Projectile vomiting containing blood
- D. Screaming and drawing the knees up to the chest
- E. Stool mixed with blood and mucus
Correct Answer: B,D,E
Rationale: Intussusception is characterized by a sausage-shaped mass, paroxysmal pain with knee-drawing, and 'currant jelly' stools.