Nokea
An infant is brought to the clinic for a regular checkup and the diphtheria, tetanus, and acellular pertussis (DTaP) and inactivated polio vaccine (IPV) immunizations. The child is recovering from a cold and is afebrile. The child's sibling has cancer and is receiving chemotherapy. Which of the following actions is most appropriate?
- A. Giving the DTaP and withholding the IPV.
- B. Administering the DTaP and IPV immunizations.
- C. Postponing both immunizations until the sibling is in remission.
- D. Withholding both immunizations until the infant is well.
Correct Answer: B
Rationale: The infant is afebrile and recovering, and neither DTaP nor IPV is live vaccines, so they are safe to administer despite the sibling's immunocompromised state.
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A client with a history of heart failure is prescribed lisinopril (Prinivil). The nurse should monitor the client for which of the following adverse effects?
- A. Hyperkalemia.
- B. Hypotension.
- C. Weight loss.
- D. Tachycardia.
Correct Answer: A, B
Rationale: Lisinopril, an ACE inhibitor, can cause hyperkalemia and hypotension.
Which statement about targeted assessments is accurate?
- A. The need for a targeted assessment is based on the application of the nurse's knowledge of pathophysiology and the presenting symptoms.
- B. The need for a targeted assessment is based on the application of the nurse's knowledge of developmental needs and developmental delays.
- C. Targeted assessment is done on an annual basis for existing clients rather than a complete assessment that is done for new clients.
- D. Targeted assessments consist of a brief medical history and a complete assessment consists of a complete health history and a complete physical assessment.
Correct Answer: A
Rationale: Targeted assessments focus on specific health issues based on the nurse's knowledge of pathophysiology and the patient's presenting symptoms, allowing for a focused evaluation rather than a comprehensive one.
Which of the following is an adverse effect to therapeutic radiation therapy?
- A. Fibrosis
- B. Alopecia
- C. Oral dryness
- D. Xerostomia
Correct Answer: D
Rationale: Xerostomia (dry mouth) is a common adverse effect of radiation therapy, particularly when the head or neck is irradiated, due to damage to salivary glands.
A client with a history of chronic pain is prescribed gabapentin (Neurontin). The nurse should instruct the client to report which of the following side effects?
- A. Drowsiness.
- B. Hypertension.
- C. Hyperglycemia.
- D. Tachycardia.
Correct Answer: A
Rationale: Gabapentin commonly causes drowsiness, which should be reported to manage safety and dosing.
The mother of a 3-year-old child tells the nurse her child is 'fussy' and not as 'easy going' as her other children. She is having difficulty feeding the child because he fusses and cries when she serves a meal. The nurse should instruct the mother to:
- A. Allow the child to determine when feeding should occur.
- B. Not to feed the child if he cries.
- C. Provide structured feeding times and routines.
- D. Give the child finger foods and let him eat when he wants.
Correct Answer: C
Rationale: Structured feeding times and routines help establish consistent eating habits, reducing fussiness by providing predictability for the child.