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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Prior to administering filgrastim, the nurse reviews the laboratory report results for the 3-year-old who completed the second round of chemotherapy three weeks ago. Which finding indicates a therapeutic response to filgrastim?
- A. Hematocrit of 31%
- B. Eosinophil count of 6%
- C. WBC count of 6800/mm3
- D. Platelet count of 150,000/mm3
Correct Answer: C
Rationale: A: The Hct of 31% is normal but is unaffected by filgrastim, a colony-stimulating factor. B: The eosinophil count of 6% is elevated (0 to 2% is normal) but is not related to filgrastim use. C: Filgrastim (Neupogen) is a colony-stimulating factor used to increase the production of WBCs in persons who have bone marrow depression from chemotherapy. D: The platelet count of 150,000/mm3 is normal but is not used to evaluate the therapeutic effectiveness of filgrastim.
The 11-year-old with type 1 DM is learning to use insulin pens for basal-bolus insulin therapy with both a very-long-acting insulin and rapid-acting insulin. Which action by the child should indicate to the nurse that additional teaching is needed?
- A. The child holds the insulin glargine pen against the skin for 10 seconds after administering the correct amount of insulin.
- B. The child counts the number of carbohydrates eaten at breakfast and selects the insulin lispro pen for covering the carbohydrates eaten.
- C. The child counts the number of carbohydrates eaten at lunch and selects the insulin glargine pen for covering the carbohydrates eaten.
- D. The child determines that the blood glucose level at bedtime is within the normal range, eats a piece of turkey, and tells the nurse that coverage is not needed with insulin lispro.
Correct Answer: C
Rationale: A: To ensure that the medication is administered with the insulin pens, the pen is held in place for 10 seconds after delivery of the medication. This action is correct. B: Insulin lispro (Humalog) is rapid-acting insulin with an onset of 5 to 10 minutes. This action is correct. C: Insulin glargine (Lantus) is very-long-acting insulin administered once daily and is not used for covering the number of carbohydrates eaten. This action indicates the child needs additional teaching. D: The rapid-acting insulin lispro (Humalog) is not needed if the glucose level is WNL. Turkey does not contain carbohydrates; insulin is administered to cover only the carbohydrates eaten. This action is correct.
The client with CRF is receiving epoetin alfa. Which finding should indicate to the nurse that the action of the medication has been effective?
- A. Urine output increased to 30 mL per hour
- B. Hemoglobin 12 g/dL and hematocrit 36%
- C. BP 110/70 mm Hg and heart rate 68 bpm
- D. Reports an increased energy level and less fatigue
Correct Answer: B
Rationale: A: Epoetin alfa does not have an effect on urine output or BP. B: Epoetin alfa stimulates erythropoiesis, or the production of RBCs. It is used in treating anemias associated with decreased RBC production, such as in renal failure. Hgb and Hct are used to evaluate the medication's effectiveness. The target Hgb for the client with CRF is 12 g/dL. C: Epoetin alfa does not have an effect on BP or HR. D: The client may report increased energy and less fatigue because of the increased Hgb levels, but these findings are not used to evaluate the medication's action.
The LPN is caring for a client admitted for acute pancreatitis. Which of these medications would be least appropriate for pain management?
- A. Tylenol
- B. Tramadol
- C. Codeine
- D. Morphine
Correct Answer: D
Rationale: Morphine is contraindicated for pain management in pancreatitis because it causes spasms in the Sphincter of Oddi.
Melissa Smith came to the Emergency Department in the last week before her estimated date of confinement complaining of headaches, blurred vision, and vomiting. Suspecting PIH, the nurse should best respond to Melissa's complaints with which of the following statements?
- A. The physician will probably want to admit you for observation.'
- B. The physician will probably order bed rest at home.'
- C. These are really dangerous signs.'
- D. The physician will probably prescribe some medicine for you.'
Correct Answer: B
Rationale: Pregnancy-induced hypertension (PIH) symptoms like headaches, blurred vision, and vomiting suggest preeclampsia, which is best managed with bed rest at home unless severe, requiring hospitalization.