Nokea
A nurse working in a geriatric clinic sees clients with cold symptoms and rhinitis. Which drug would be appropriate to teach these clients to take for their symptoms?
- A. Chlorphenamine (Chlor-Trimeton)
- B. Diphenhydramine (Benadryl)
- C. Fexofenadine (Allegra)
- D. Hydroxyzine (Vistaril)
Correct Answer: C
Rationale: First-generation antihistamines are not appropriate for use in the older population. These drugs include chlorphenamine, diphenhydramine, and hydroxyzine. Fexofenadine is a second-generation antihistamine, which is safer and more suitable for older adults.
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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 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.
A client is in the family practice clinic reporting a severe cough that has lasted for 5 weeks. The client is so exhausted after coughing that work has become impossible. What action by the nurse is most appropriate?
- A. Arrange for immediate hospitalization.
- B. Facilitate polymerase chain reaction testing.
- C. Have the client produce a sputum sample.
- D. Obtain two sets of blood cultures.
Correct Answer: B
Rationale: Polymerase chain reaction testing is used to diagnose pertussis, which this client is showing manifestations of. This is the most appropriate action to confirm the diagnosis.
A client has been taking isoniazid (INH) for tuberculosis for 3 weeks. What laboratory results need to be reported to the health care provider immediately?
- A. Albumin: 5.1 g/dL.
- B. Alanine aminotransferase (ALT): 180 U/L.
- C. Red blood cell (RBC) count: 5.2 million/mm³.
- D. White blood cell (WBC) count: 12,500/mm³.
Correct Answer: B
Rationale: INH can cause liver damage, especially if the client drinks alcohol. The ALT (one of the liver enzymes) is extremely high and needs to be reported immediately, as it indicates potential liver toxicity.
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.