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An African-American woman had experienced severe palpitations, weakness, and shortness of breath after taking bacitracin (Bactrim). As a part of the discharge planning, the nurse should evaluate the client's knowledge about:
- A. Increased folic acid needs.
- B. Congenital enzyme deficiency.
- C. Restricted activity in hot weather.
- D. Need for blood transfusions.
Correct Answer: B
Rationale: Bactrim (sulfamethoxazole/trimethoprim) can cause hemolytic anemia in individuals with glucose-6-phosphate dehydrogenase (G6PD) deficiency, a congenital enzyme deficiency common in African-American populations. The nurse should assess the client's understanding of G6PD deficiency and how to avoid triggers like certain medications. Folic acid, activity restrictions, and transfusions are not directly related.
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The client with a major burn injury receives total parenteral nutrition (TPN). The expected outcome is to:
- A. Correct water and electrolyte imbalances.
- B. Allow the gastrointestinal tract to rest.
- C. Provide supplemental vitamins and minerals.
- D. Ensure adequate caloric and protein intake.
Correct Answer: D
Rationale: Major burn injuries significantly increase metabolic demands, requiring high caloric and protein intake to support healing and tissue repair. TPN is primarily used to meet these nutritional needs when oral or enteral feeding is not feasible.
Which of the following is normal for a client during the icteric phase of viral hepatitis?
- A. Tarry stools.
- B. Yellowed sclera.
- C. Shortness of breath.
- D. Light, frothy urine.
Correct Answer: B
Rationale: The icteric phase involves jaundice, causing yellowed sclera (B) due to bilirubin buildup. Tarry stools (A) indicate bleeding, not typical. Shortness of breath (C) and frothy urine (D) are unrelated.
Which of the following factors places a client at greatest risk for skin cancer?
- A. Fair skin and history of chronic sun exposure.
- B. Caucasian race and history of hypertension.
- C. Dark skin and family history of skin cancer.
- D. Dark skin and history of hypertension.
Correct Answer: A
Rationale: Fair skin and chronic sun exposure increase skin cancer risk due to higher UV sensitivity and cumulative damage. Dark skin offers some protection.
Because a client has a Thomas splint, the nurse should assess the client regularly for which of the following?
- A. Signs of skin pressure in the groin area.
- B. Evidence of decreased breath sounds.
- C. Skin breakdown behind the heel.
- D. Urine retention.
Correct Answer: A
Rationale: The Thomas splint can cause pressure in the groin, requiring regular skin assessments to prevent breakdown.
Which of the following interventions should the nurse include in the client's plan of care to prevent complications associated with TPN administered through a central line?
- A. Use a clean technique for all dressing changes.
- B. Tape all connections of the system.
- C. Encourage bed rest.
- D. Cover the insertion site with a moisture-proof dressing.
Correct Answer: B,D
Rationale: To prevent complications with TPN via a central line, taping all connections (B) prevents dislodgement, and a moisture-proof dressing (D) reduces infection risk. Clean technique (A) is insufficient; sterile technique is required. Bed rest (C) is not necessary and may increase complications like thrombosis. CN: Pharmacological and parenteral therapies; CL: Create