Nokea
A pregnant Asian client who is experiencing morning sickness wants to take ginger to relieve the nausea. Which of the following responses by the nurse is appropriate?
- A. I will call your physician to see if we can start some ginger.'
- B. We don't use home remedies in this clinic.'
- C. Herbs are not as effective as regular medicines.'
- D. Just eat some dry crackers instead.'
Correct Answer: A
Rationale: This statement reveals cultural sensitivity. Ginger is sometimes used to relieve nausea. The other statements are culturally insensitive and do not show an awareness of herbal pharmacology.
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The LPN is taking care of a client with a documented allergy to Penicillin. After rounds, the PN notices that the client has an order for Cefazolin. Which of the following actions would be the least appropriate?
- A. The LPN clarifies the severity of the Penicillin allergy.
- B. The LPN discusses the order with the care team prior to administering Cefazolin.
- C. The LPN administers all ordered medications except for the Cefazolin.
- D. The LPN monitors the client after a test dose of Cefazolin is administered.
Correct Answer: C
Rationale: The LPN should clarify the order with the care team prior to determining the medication should not be given. Even though the client may have a potential reaction due to the Penicillin allergy, the therapeutic benefits of the antibiotic may outweigh the allergic reaction.
A pregnant client asks how she can prevent getting Group B Strep. What is the LPN's best response?
- A. You should have your partner wear a condom every time you have intercourse.
- B. You cannot prevent getting Group B Strep, you can only treat it.
- C. You should be extra vigilant about hand-washing, especially in the third trimester.
- D. The Group B Strep vaccine is the only proven way to prevent the disease.
Correct Answer: B
Rationale: Group B Strep lives in the vagina, rectum, and intestines of about 25% of the female population. It is considered normal flora and is not a sexually transmitted disease. The same woman can test positive in one pregnancy and negative in another, which is why testing is done every pregnancy, usually within 5 weeks of expected delivery. If a woman tests positive for Group B Strep, she will be given antibiotics during delivery to greatly reduce the risk of complications for her and her baby.
The nurse is caring for the child from Italy. The child is crying, and the interpreter is stating that the child has extreme pain. What should be the nurse's priority?
- A. Administer morphine sulfate 1 mg intravenously as prescribed.
- B. Have the child's mother, who knows limited English, ask the child what hurts.
- C. Assess the level of the child's pain using an appropriate FACES pain rating scale.
- D. Ask the HCP to change the pain medication dosage due to inadequate pain control.
Correct Answer: C
Rationale: A: The nurse's judgment regarding the choice of pain medication and dose should be based on the reported level of pain. B: The nurse should do an independent assessment because sometimes information can be misinterpreted if there is limited knowledge of the language. C: Assessment should be completed prior to a pain intervention. The FACES pain-rating scale has been translated into a variety of languages. D: There is no information indicating the need for the pain medication dose to be changed.
The nurse completed teaching for the client who will be receiving TPN at home. Which client statement indicates that further teaching is needed?
- A. My refrigerator is big enough to store several bags of parenteral solution.
- B. I will keep my cellular phone with me at all times to use in an emergency.
- C. I plan to use the main floor bedroom; it'll be best with the infusion pump.
- D. I'll sit at the table to remove the IV catheter cap to attach the IV tubing.
Correct Answer: D
Rationale: A: Several total nutrient solution bags are kept on hand and require refrigeration. B: A telephone is necessary for contacting home health personnel, arranging for supply deliveries, and calling emergency services. C: The TPN is delivered through an infusion pump, which can limit the client's mobility. D: The central catheter lumen is capped with a needleless port. The IV infusion tubing is connected to the insertion site cap and not removed to administer the TPN solution. Caps are changed every 3 to 7 days during dressing changes, with the client in a flat position. An air embolus can occur if the cap is removed while the client is in a sitting position.
The nurse is reviewing client information for adverse effects of trazodone. Which finding should the nurse identify as an adverse effect unique to trazodone?
- A. Priapism
- B. Weight gain
- C. Hepatic failure
- D. Cardiac dysrhythmias
Correct Answer: A
Rationale: Prolonged or inappropriate erections (priapism) are a rare but problematic side effect of treatment with trazodone (Oleptro).