Nokea
An adult client tells the clinic nurse that he is susceptible to middle ear infections. About which risk factor related to infection of the ears does the nurse question this client?
- A. Loud music
- B. Use of power tools
- C. Occupational noise
- D. Exposure to cigarette smoke
Correct Answer: D
Rationale: The correct answer is 'Exposure to cigarette smoke.' Otitis media (middle ear infection) is associated with various factors like colds, allergies, sore throats, and blockage of the eustachian tubes. Risk factors include exposure to cigarette smoke, youth (as otitis media is usually a childhood disease), congenital abnormalities, immune deficiencies, family history of otitis media, recent upper respiratory infections, and allergies. Choices A, B, and C (Loud music, Use of power tools, and Occupational noise) are more likely to cause hearing loss rather than being direct risk factors for middle ear infections.
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The LPN is admitting a client to the unit, and the client has rapidly blinking eyes, a stuck-out tongue, and a distorted posture. Which of these medications is the client most likely taking?
- A. Clozapine
- B. Fluoxetine
- C. Ondansetron
- D. Haloperidol
Correct Answer: D
Rationale: The correct answer is Haloperidol. Haloperidol is a first-generation antipsychotic that blocks dopamine receptors and is most likely to cause extrapyramidal symptoms (EPS), such as tardive dyskinesia. Symptoms of tardive dyskinesia include rapid blinking, mouth movements, sticking out the tongue, rapid body movements, and a distorted posture. Haloperidol is associated with a higher risk of EPS compared to other antipsychotic medications like Clozapine. Clozapine is known for having a lower risk of causing EPS. Fluoxetine is a selective serotonin reuptake inhibitor used for depression and anxiety, not typically associated with these movement disorder symptoms. Ondansetron is an antiemetic used to prevent nausea and vomiting, not linked to these extrapyramidal symptoms.
Local anesthetics block the conduction of pain impulses to the spinal cord. Their duration of action:
- A. is always longer than general anesthesia.
- B. is determined by the rate of diffusion and absorption at the site of administration.
- C. is usually short (10 minutes).
- D. varies, depending on the client's weight.
Correct Answer: B
Rationale: Diffusion and absorption depend on the chemical properties of the anesthetic and other factors such as local pH and blood flow. Duration might or might not be longer than general anesthesia. Duration can be short if the type of local anesthetic is a short-acting agent. Client weight is not a factor.
When caring for an elderly client and providing education, which of the following would be the least appropriate for the nurse to do?
- A. The nurse speaks loudly.
- B. The nurse allows additional time after each instruction to allow the client to process.
- C. The nurse provides supplemental written resources.
- D. The nurse breaks up the education into multiple shorter sessions.
Correct Answer: A
Rationale: Speaking loudly is inappropriate when caring for an elderly client. It is essential to assess the client for a hearing impairment and provide appropriate assistance if needed. Elderly clients may require more time to process information due to slower reaction times, benefit from shorter sessions as they fatigue easily, and can absorb supplemental written resources effectively. Therefore, speaking loudly may not be conducive to effective communication and may not cater to the specific needs of the elderly client, unlike the other options provided.
A client complains that her skin is redder than normal. The nurse notes the client's skin, documents hyperemia, and explains to the client that this condition is caused by which factor?
- A. Constriction of the underlying blood vessels
- B. An increased amount of bilirubin in the blood
- C. Increased perfusion of the surrounding tissues
- D. Excess blood in the dilated superficial capillaries
Correct Answer: D
Rationale: Hyperemia is an excess of blood in a part of the body. The skin over a hyperemic area usually becomes reddened or warm. The condition is caused by increased blood flow, local relaxation of arterioles, or obstruction of the outflow of blood from an area. Choice A is incorrect because constriction of blood vessels would lead to decreased blood flow, not excess blood. Choice B is incorrect as an increased amount of bilirubin in the blood is related to jaundice, not hyperemia. Choice C is incorrect because increased perfusion of the surrounding tissues would cause redness, not hyperemia.
Which of the following clients should refrain from therapy with the thiazide diuretic hydrochlorothiazide (HCTZ)?
- A. A client with renal impairment
- B. A client with hypertension
- C. A client with diabetes mellitus, type II
- D. A client with renal calculi (kidney stones)
Correct Answer: C
Rationale: Thiazides can elevate blood glucose by causing hypokalemia, which reduces insulin secretion, making them unsuitable for clients with type II diabetes.