Nokea
An adult who has myasthenia gravis is about to be discharged. Neostigmine is prescribed for her. What should the nurse include when teaching the client about this drug? Tell the client to take the drug:
- A. one-half hour before meals.
- B. between meals.
- C. immediately following meals.
- D. upon arising and at bedtime.
Correct Answer: A
Rationale: Taking neostigmine 30 minutes before meals maximizes muscle strength for chewing and swallowing, critical for myasthenia gravis patients, unlike other timing.
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A 3-year-old child who is up to date with all immunizations is seen at clinic. The child has a fever of 102°F and a pruritic rash with fluid-filled vesicles that began on the trunk. The physician says the child has varicella. The child's mother says to the nurse, 'I thought my child couldn't get this because she had all her shots.' What is the best response for the nurse to make?
- A. You child probably did not respond to the vaccine as most children do.
- B. The nurse must not have administered it correctly.
- C. It is still possible to contract the illness, but your child will most likely have a less severe case.
- D. The vaccine is only effective after the child has received two doses.
Correct Answer: C
Rationale: The varicella vaccine reduces severity but does not guarantee immunity; breakthrough cases are milder, as indicated by the child's symptoms.
The nurse is caring for a 79-year-old client. Which observation is not normal and should be reported for follow-up?
- A. The client has several brown spots on her cheek and neck.
- B. The client says, 'I move slower than I used to.'
- C. The client is short of breath when walking down the hall.
- D. The client says, 'I have trouble telling the colors of my socks.'
Correct Answer: C
Rationale: Shortness of breath with exertion may indicate cardiovascular or respiratory issues, requiring follow-up. Brown spots, slower movement, and color vision changes are normal aging signs.
A client with chronic obstructive pulmonary disease (COPD) and a history of coronary artery disease is receiving aminophylline, 25 mg/hour. Which one of the following findings by the nurse would require immediate intervention?
- A. Decreased blood pressure and respirations
- B. Flushing and headache
- C. Restlessness and palpitations
- D. Increased heart rate and blood pressure
Correct Answer: C
Rationale: Restlessness and palpitations. Side effects of Aminophylline include restlessness and palpitations.
The nurse is caring for a client with heart failure.
- A. Which symptom indicates worsening heart failure in a client?
- B. Weight gain of 2 pounds in 24 hours.
- C. Decreased blood pressure.
- D. Clear lung sounds bilaterally.
- E. Improved exercise tolerance.
Correct Answer: A
Rationale: A weight gain of 2 pounds in 24 hours indicates fluid retention, a sign of worsening heart failure. Decreased blood pressure may occur but is less specific, clear lung sounds suggest stability, and improved exercise tolerance indicates improvement.
A home care nurse is planning activities for the day. Which of the following clients should the nurse see FIRST?
- A. A new mother is breastfeeding her two-day-old infant who was born five days early.
- B. A man discharged yesterday following treatment with IV heparin for a deep vein thrombosis.
- C. An elderly woman discharged from the hospital three days ago with pneumonia.
- D. An elderly man who used all his diuretic medication and is expectorating pink-tinged mucus.
Correct Answer: D
Rationale: symptoms of pulmonary edema; requires immediate attention