Nokea
Around what age do children start to develop "stranger anxiety"?
- A. 9 months
- B. 6 months
- C. 3 months
- D. 12 months
Correct Answer: B
Rationale: By 6 months, children should be able to recognize familiar faces, and thus they are aware of strangers. Strangers may illicit anxiety.
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The 40-year-old client is receiving levothyroxine for treatment of hypothyroidism. Which serum laboratory results should lead the nurse to conclude that the client's dose is adequate?
- A. Thyroid-stimulating hormone and cortisol
- B. Thyroid-stimulating hormone and free T4
- C. Triiodothyronine (T3) and free thyroxine (T4)
- D. White blood cells, glucose, and potassium
Correct Answer: B
Rationale: A: Cortisol levels are used to evaluate adrenal and not thyroid function. B: Restoration of normal laboratory values for TSH and free T4 indicates that the dose of levothyroxine (Synthroid) is therapeutic. C: T3 is used to evaluate the effectiveness of liothyronine and propylthiouracil, used in the treatment of thyroid disorders. D: The WBC count is used to determine if the client has an infection. Evaluation of serum glucose and potassium levels is unrelated to the use of levothyroxine.
The home care nurse is observing the child with asthma self-administer a dose of albuterol via a metered-dose inhaler with a spacer. Within a short time, the child begins to wheeze loudly. What should the nurse do?
- A. Reassure the parent that this usually only occurs with the initial dose.
- B. Notify the HCP; wheezing may indicate paradoxical bronchospasms.
- C. Consult with the HCP to have the child's medication dosage increased.
- D. Reassess the technique; eye contact with albuterol can cause wheezing.
Correct Answer: B
Rationale: A: Reassuring the parent is an inappropriate action; the wheezing is not a normal reaction. There is no indication that this is an initial dose. B: The client's wheezing suggests paradoxical bronchospasms, which can occur with excessive use of adrenergic bronchodilators such as albuterol (Proventil). The medication should be withheld and the HCP notified. C: A paradoxical bronchospasm can occur from excessive use, so the dosage should not be increased. D: Contact with the eyes can cause eye irritation, not wheezing.
Which of the following is not a nursing responsibility when preparing the client for central line insertion?
- A. advancing the guidewire
- B. explaining the procedure to the client
- C. maintaining sterile technique
- D. ensuring necessary consents are signed
Correct Answer: A
Rationale: The nursing responsibilities include explaining the procedure to the client, ensuring necessary consents are signed according to the facility policy, and maintaining sterile technique when preparing the equipment and supplies. The guidewire will be advanced by the practitioner inserting the central line.
The LPN is taking care of a client who is on Phenelzine (Nardil) for depression. Which meal would the nurse encourage the client to avoid?
- A. steak and potatoes
- B. prosciutto and cheese plate
- C. orange juice and toast
- D. carbonated water, shrimp and rice
Correct Answer: B
Rationale: Phenelzine (Nardil) is a type of MAOI (Monoamine Oxidase Inhibitor). Clients on these drugs should avoid foods and beverages with large amounts of tyramine, as they may cause dangerous elevations in blood pressure. Common foods high in tyramine include aged meats and cheeses, beer, sauerkraut, and soy sauce.
The 11-year-old with type 1 DM is learning to use insulin pens for basal-bolus insulin therapy with both a very-long-acting insulin and rapid-acting insulin. Which action by the child should indicate to the nurse that additional teaching is needed?
- A. The child holds the insulin glargine pen against the skin for 10 seconds after administering the correct amount of insulin.
- B. The child counts the number of carbohydrates eaten at breakfast and selects the insulin lispro pen for covering the carbohydrates eaten.
- C. The child counts the number of carbohydrates eaten at lunch and selects the insulin glargine pen for covering the carbohydrates eaten.
- D. The child determines that the blood glucose level at bedtime is within the normal range, eats a piece of turkey, and tells the nurse that coverage is not needed with insulin lispro.
Correct Answer: C
Rationale: A: To ensure that the medication is administered with the insulin pens, the pen is held in place for 10 seconds after delivery of the medication. This action is correct. B: Insulin lispro (Humalog) is rapid-acting insulin with an onset of 5 to 10 minutes. This action is correct. C: Insulin glargine (Lantus) is very-long-acting insulin administered once daily and is not used for covering the number of carbohydrates eaten. This action indicates the child needs additional teaching. D: The rapid-acting insulin lispro (Humalog) is not needed if the glucose level is WNL. Turkey does not contain carbohydrates; insulin is administered to cover only the carbohydrates eaten. This action is correct.