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After 12 months of cessation of menses, which of the following assessment findings in a client who is taking hormone replacement therapy should the nurse report to the physician immediately?
- A. breast tenderness
- B. weight gain
- C. fluid retention
- D. uterine bleeding
Correct Answer: D
Rationale: Uterine bleeding on combination hormone replacement therapy, after 12 months of menses cessation, indicates an increased risk of carcinoma and should be reported to the physician immediately. Breast tenderness, weight gain, and fluid retention are all routine side effects of hormone replacement therapy. They should be noted in the record and reported to the physician, but they are not urgent.
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The school nurse is conducting health screenings on schoolchildren. During the screening, she identifies a child with the behavioral characteristics of attention deficit disorder. Which of the following behaviors is consistent with this disorder?
- A. slow speech development
- B. overreaction to stimuli from the surroundings
- C. inability to carry on a conversation
- D. concrete thinking
Correct Answer: B
Rationale: Children with attention deficit disorder are easily distracted but are able to carry on a conversation. Concrete thinking is more indicative of age, and slow speech development has more to do with other learning disabilities.
The physician orders the antibiotics ampicillin (Omnipen) and gentamicin (Garamycin) for a newly admitted client with an infection. The nurse should:
- A. administer both medications simultaneously.
- B. give the medications sequentially, and flush well between them.
- C. ask the physician or pharmacy which medication to give first and how long to wait before giving the other drug.
- D. start one medication now and begin the other medication in 2-4 hours.
Correct Answer: B
Rationale: A client with an infection needs both antibiotics as soon as possible. However, the pH of ampicillin is 8-10, and the pH of gentamicin is 3-5.5 (making them incompatible when given together). Flushing well between drugs is necessary.
A client asks the nurse what risk factors increase the chances of getting skin cancer. The risk factors include all except:
- A. Light or fair complexion
- B. Exposure to sun for great periods of time
- C. Certain diet and foods
- D. History of bad sunburns
Correct Answer: C
Rationale: Diet and foods are not established risk factors for skin cancer, unlike fair complexion, sun exposure, and history of sunburns.
Which of the following client groups should the nurse recognize as the fastest-growing segment of the homeless population?
- A. Single, adult men
- B. Single mothers with 2 or 3 children
- C. Runaway adolescents
- D. Single, adult women
Correct Answer: B
Rationale: Single mothers with two or three children are the fastest-growing segment of the homeless population, often with young children, due to economic and social challenges.
A patient has been admitted to the hospital with a HNP L4-5 segment diagnosis. After 24 hours the patient is able to ambulate with assistance with reduced muscle spasms. Which of the following medications was the most beneficial in changing the patient's mobility status?
- A. Mivacron
- B. Atropine
- C. Bethanechol
- D. Flexeril
Correct Answer: D
Rationale: Flexeril is a muscle relaxant for acute muscle pain and spasms.