Nokea
A nurse is reinforcing teaching about fluticasone topical lotion with the parent of a 9-month-old infant who has atopic dermatitis on the wrist. Which of the following instructions should the nurse include?
- A. Place a thick layer of the medication on open areas.'
- B. Rub the medication until it disappears.'
- C. Cover the area with an occlusive dressing.'
- D. Apply the medication to your infant's entire arm.'
Correct Answer: B
Rationale: The correct answer is B: Rub the medication until it disappears. This instruction is appropriate because it ensures proper absorption of the medication into the skin, maximizing its effectiveness. Rubbing the lotion helps distribute it evenly and facilitates absorption, which is crucial for treating atopic dermatitis.
Choice A is incorrect because applying a thick layer can lead to overuse of the medication and potential side effects. Choice C is incorrect as using an occlusive dressing can increase the risk of skin irritation and worsen the condition. Choice D is incorrect because applying the medication to the entire arm may not be necessary and could lead to unnecessary exposure. It is essential to focus on the affected area only.
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A nurse is caring for a client who is receiving filgrastim. The nurse should monitor the client for which of the following adverse effects?
- A. Hypertension
- B. Fluid retention
- C. Bone pain
- D. Hypokalemia
Correct Answer: C
Rationale: The correct answer is C: Bone pain. Filgrastim is a medication that stimulates the production of white blood cells. Bone pain is a common adverse effect because it indicates the bone marrow is producing more cells. Monitoring for bone pain is crucial to assess the effectiveness of the medication. Hypertension (A) and fluid retention (B) are not typically associated with filgrastim. Hypokalemia (D) is not a common adverse effect of filgrastim.
A nurse in a clinic is preparing to administer the measles, mumps, rubella (MMR) vaccine to a client. Which of the following findings should indicate to the nurse that the client has a contraindication for the MMR vaccine?
- A. The client had a local reaction from a previous immunization
- B. The client reports having diarrhea this morning
- C. The client is at 9 weeks of gestation
- D. The client reports an allergy to penicillin.
Correct Answer: C
Rationale: The correct answer is C: The client is at 9 weeks of gestation. Administering the MMR vaccine during pregnancy is contraindicated due to the theoretical risk of causing harm to the fetus. The live attenuated MMR vaccine should not be given to pregnant women as it may potentially harm the developing fetus. It is crucial to avoid administration during pregnancy to prevent any adverse effects on the unborn child.
Other options are incorrect because:
A: The client had a local reaction from a previous immunization - Local reactions to previous vaccines are not contraindications to receiving the MMR vaccine.
B: The client reports having diarrhea this morning - Diarrhea is not a contraindication for the MMR vaccine.
D: The client reports an allergy to penicillin - Allergy to penicillin is not a contraindication for the MMR vaccine.
A nurse is reinforcing teaching with a client who has schizophrenia and a new prescription for haloperidol. The nurse should instruct the client to avoid taking which of the following medications?
- A. Diphenhydramine
- B. Docusate sodium
- C. Ibuprofen
- D. Glucosamine
Correct Answer: A
Rationale: The correct answer is A: Diphenhydramine. Haloperidol and diphenhydramine both have sedative effects and can cause additive central nervous system depression when taken together. This can lead to increased drowsiness, confusion, and impaired coordination. Docusate sodium (B), ibuprofen (C), and glucosamine (D) do not have significant interactions with haloperidol. It is important for the client to avoid diphenhydramine to prevent potential adverse effects.
A nurse is planning care for a client who has angina and a new prescription for nitroglycerin ointment. Which of the following actions should the nurse plan to take?
- A. Cover the administration area with plastic wrap.
- B. Massage the ointment into the skin.
- C. Spread the ointment in a 10 cm2 (4in2) area.
- D. Apply the ointment in a thick layer.
Correct Answer: A
Rationale: The correct answer is A. The nurse should cover the administration area with plastic wrap when applying nitroglycerin ointment to prevent accidental exposure to others and to ensure proper absorption of the medication. This step helps to enhance the drug's efficacy by promoting direct contact with the skin and preventing it from being rubbed off onto clothing or other surfaces. Massaging the ointment into the skin (B) may alter the absorption rate and distribution of the medication. Spreading the ointment in a 10 cm2 area (C) may lead to inaccurate dosing. Applying the ointment in a thick layer (D) may result in overdose or underdose due to inconsistent dosing.
A nurse is collecting data from a client who received diphenhydramine 1 hr ago after developing an allergic reaction to trimethoprim-sulfamethoxazole. Which of the following statements by the client should indicate to the nurse that the medication is effective?
- A. My appetite is increased.'
- B. I don't have a headache anymore.'
- C. My voice is no longer hoarse.'
- D. I am feeling more alert.'
Correct Answer: C
Rationale: The correct answer is C: "My voice is no longer hoarse." This statement indicates the effectiveness of diphenhydramine, an antihistamine used to treat allergic reactions. Hoarseness is a common symptom of allergic reactions, so if the client's voice is no longer hoarse, it suggests that the medication has alleviated the allergic response.
A: Increased appetite is not a direct indicator of the effectiveness of diphenhydramine in treating an allergic reaction.
B: Relief from headaches is not a specific symptom related to allergic reactions or a typical indicator of diphenhydramine effectiveness.
D: Feeling more alert is not a direct indicator of the effectiveness of diphenhydramine in treating allergic reactions.
Therefore, option C is the most appropriate choice as it directly relates to the specific symptom of the allergic reaction that diphenhydramine is intended to treat.