Nokea
A nurse is reviewing the medical record of a client who is to start using a scopolamine patch for postoperative nausea and vomiting. Which of the following findings is a contraindication for the client to receive the medication?
- A. Ménière's disease
- B. Increased lacrimation
- C. Narrow-angle glaucoma
- D. Urinary frequency
Correct Answer: C
Rationale: The correct answer is C: Narrow-angle glaucoma. Scopolamine can cause pupillary dilation, leading to an increase in intraocular pressure, which can worsen narrow-angle glaucoma. This can potentially result in a sudden increase in pressure within the eye, leading to severe pain, vision changes, and even blindness. Therefore, it is crucial to avoid giving scopolamine to clients with narrow-angle glaucoma to prevent these serious complications.
Choice A: Ménière's disease is not a contraindication for scopolamine patch use.
Choice B: Increased lacrimation is not a contraindication for scopolamine patch use.
Choice D: Urinary frequency is not a contraindication for scopolamine patch use.
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A nurse is reinforcing teaching with the parents of a 1-year-old client following the administration of the measles, mumps, and rubella virus vaccine (MMR). Which of the following adverse effects should the nurse instruct the parents to report to the provider?
- A. Glandular swelling around the jaw
- B. Redness around the injection site
- C. Temperature 37.3° C (99.2° F)
- D. Shortness of breath
Correct Answer: D
Rationale: The correct answer is D: Shortness of breath. Shortness of breath can indicate a severe allergic reaction or anaphylaxis, which is a rare but serious adverse effect of the MMR vaccine. It is crucial to report this immediately to the healthcare provider for prompt evaluation and management to prevent any complications.
A: Glandular swelling around the jaw is a common and mild side effect of the MMR vaccine, typically resolving on its own and not requiring immediate medical attention.
B: Redness around the injection site is a common and expected reaction to the vaccine, usually resolving without intervention.
C: A temperature of 37.3° C (99.2° F) is a low-grade fever, which can be a normal response to vaccination and typically does not require urgent medical attention.
A nurse is reinforcing teaching about the pledge program with a female client who has a new prescription for…. The nurse should tell the client that which of the following is a requirement of the program?
- A. Clients must have a Papanicolaou test every 6 months during treatment.
- B. Clients must begin a daily supplement of vitamin A for 1 month prior to initiating therapy.
- C. Sexually active female clients must use two forms of birth control during treatment.
- D. Female clients must have a negative mammogram prior to beginning therapy.
Correct Answer: C
Rationale: The correct answer is C: Sexually active female clients must use two forms of birth control during treatment. This requirement is crucial to prevent pregnancy due to the potential teratogenic effects of the medication on the fetus. Using two forms of birth control provides an extra layer of protection.
Other choices are incorrect:
A: Having a Papanicolaou test every 6 months is not a specific requirement of the program.
B: Starting a daily supplement of vitamin A is not a requirement for the pledge program.
D: Having a negative mammogram is not directly related to the pledge program's requirements.
A nurse is caring for a client who is immunosuppressed. The nurse should identify that which of following immunizations is contraindicated for this client?
- A. Pneumococcal
- B. Meningococcal
- C. Inactivated influenza
- D. Varicella
Correct Answer: D
Rationale: The correct answer is D: Varicella. The client is immunosuppressed, so live vaccines like varicella should be avoided to prevent potential complications. Live vaccines can cause infection in immunocompromised individuals. Pneumococcal, Meningococcal, and Inactivated influenza vaccines are safe for immunosuppressed clients as they are not live vaccines. Varicella is contraindicated due to the risk of causing varicella infection in an immunocompromised individual.
A nurse is collecting data from a client who is experiencing oxycodone toxicity. Which of the following findings should the nurse expect?
- A. Tachypnea
- B. Sedation
- C. Dilated pupils
- D. Tachycardia
Correct Answer: B
Rationale: The correct answer is B: Sedation. Oxycodone is an opioid that depresses the central nervous system, leading to sedation as a common manifestation of toxicity. Tachypnea (A) is more commonly associated with opioid withdrawal rather than toxicity. Dilated pupils (C) are more indicative of stimulant toxicity, not opioids. Tachycardia (D) is unlikely with oxycodone toxicity due to its depressant effects on the cardiovascular system. Other choices are not relevant to oxycodone toxicity.
A nurse is talking with a client who has been taking levothyroxine to treat hypothyroidism. The nurse should instruct the client to avoid taking which of the following over-the-counter medications within 4 hr of taking levothyroxine?
- A. Fish oil supplements
- B. Bulk-forming laxatives
- C. Oral antihistamines
- D. Calcium supplements
Correct Answer: D
Rationale: The correct answer is D: Calcium supplements. Calcium can interfere with the absorption of levothyroxine, reducing its effectiveness. It is recommended to avoid taking calcium supplements within 4 hours of levothyroxine to ensure proper absorption. Fish oil supplements (A), bulk-forming laxatives (B), and oral antihistamines (C) do not typically interfere with levothyroxine absorption, so they are safe to take without waiting 4 hours.