Nokea
A patient with COPD is reporting depression and thoughts of suicide. The patient states, 'I just feel like ending it all.' You assess the patient's health history and note that the patient was recently started on which medication that could cause this side effect:
- A. Atrovent
- B. Prednisone
- C. Roflumilast
- D. Theophylline
Correct Answer: C
Rationale: Roflumilast is associated with psychiatric side effects, including depression and suicidal thoughts. Other medications (A, B, D) are less commonly linked to these effects.
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Which assessment data indicate to the nurse the client diagnosed with Legionnaires' disease is experiencing a complication?
- A. The client has an elevated body temperature.
- B. The client has less than 30 mL urine output an hour.
- C. The client has a decrease in body aches.
- D. The client has an elevated white blood cell count.
Correct Answer: B
Rationale: Oliguria (<30 mL/hr, B) indicates renal failure, a serious complication of Legionnaires' disease due to systemic infection or shock. Fever (A) and elevated WBC (D) are expected in active infection, not complications. Decreased body aches (C) suggests improvement, not a complication.
The client diagnosed with tonsillitis is scheduled to have surgery in the morning. Which assessment data should the nurse notify the health-care provider about prior to surgery?
- A. The client has a hemoglobin of 12.2 g/dL and hematocrit of 36.5%.
- B. The client has an oral temperature of 100.2°F and a dry cough.
- C. There are one (1) to two (2) white blood cells (WBCs) in the urinalysis.
- D. The client's current international normalized ratio (INR) is 1.
Correct Answer: B
Rationale: Fever (100.2°F) and cough (B) suggest infection, a surgical risk requiring HCP notification. Hb/Hct (A) are near normal, WBCs in urine (C) are insignificant, and INR 1 (D) is normal.
A patient is taking Streptomycin. Which finding below requires the nurse to notify the physician?
- A. Patient reports a change in vision.
- B. Patient reports a metallic taste in the mouth.
- C. The patient has ringing in their ears.
- D. The patient has a persistent dry cough.
Correct Answer: C
Rationale: This medication can be very toxic to the ears (cranial nerve 8). Therefore, it is alarming if the patient reports ringing in their ears, which could represent ototoxicity.
A farmer who has had a cough for several months has noticed a lack of energy lately. He is being tested for histoplasmosis. Which factor reported by the client would be most related to the diagnosis of histoplasmosis?
- A. He drinks raw milk.
- B. He cleans chicken houses.
- C. He handles fertilizer frequently.
- D. He stepped on a rusty nail recently.
Correct Answer: B
Rationale: Cleaning chicken houses exposes the client to bird droppings, a common source of Histoplasma capsulatum, the fungus causing histoplasmosis.
A client who had a laryngectomy is nearly ready for discharge. Which instruction is most appropriate for the nurse to give?
- A. Always be sure you have a buddy with you when you go swimming or boating.'
- B. You may take a tub bath, but you should not take a shower.'
- C. Be sure to have only liquids for another three weeks.'
- D. Never cover your stoma with anything.'
Correct Answer: A
Rationale: A buddy is essential during swimming or boating to ensure safety, as water entering the stoma can cause aspiration.