Nokea
Client education by the nurse entails:
- A. Telling the client everything about his disease, what is going to happen in the course of the disease, and the outcome
- B. Giving information to the client that is accurate and understandable
- C. Telling the client that the pain he experiences might not be real
- D. Giving the client medication when pain is experienced
Correct Answer: B
Rationale: Client education entails giving the client accurate and understandable information to promote understanding and engagement in their care. The other options are either inappropriate or incomplete.
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The LPN is caring for a 9 month-old infant. Which of these behaviors exhibited by the child warrants further investigation?
- A. She prefers crawling and is making no attempt to walk.
- B. She seems distressed with new adults.
- C. She does not respond to her own name.
- D. She only babbles "mama" and "dada."
Correct Answer: C
Rationale: By 9 months, children should be babbling simple words and crawling, and they should recognize and respond to their own name. They may begin attempting to walk or may just be starting to attempt to pull themselves up to stand. Strangers often produce fear or anxiety in infants this age.
The nurse administers risperidone to the client experiencing hallucinations. Which physiological disorder should the nurse assess for considering the risk of developing this disorder as a side effect of risperidone?
- A. Asthma
- B. Hypertension
- C. Crohn's disease
- D. Diabetes mellitus
Correct Answer: D
Rationale: Risperidone (Risperdal) increases the risk of diabetes, especially in the first few months of therapy.
The client taking sertraline for treatment of depression for the past 11 months reports feeling much better and wishes to discontinue the medication. Which is the nurse's most appropriate response?
- A. The medication will have to be reduced gradually to prevent undesirable symptoms.
- B. You should not stop the medication without talking to your health care provider first.
- C. It appears that the medication has worked very well. It should be safe to discontinue its use.
- D. You should take this medication indefinitely to prevent recurrence of depressive symptoms.
Correct Answer: A
Rationale: Sertraline (Zoloft) is an SSRI antidepressant. Stopping these abruptly can cause withdrawal symptoms. The dose should be reduced gradually.
The LPN is caring for a client newly diagnosed with HIV. Which statement made by the client regarding antiretroviral therapy (ART) would require correction from the nurse?
- A. If I start ART and use condoms, I'm less likely to transmit HIV to my partner.
- B. I can still use ART even though I am Hepatitis C positive.
- C. I will need to be on ART indefinitely.
- D. I know I will need to come back for blood draws so that I can begin ART when my CD4 count is over 1,000 cells/mm3.
Correct Answer: D
Rationale: The World Health Organization (WHO) recommends making treatment for those with a CD4 count of ≤ 350 cells/mm3 a priority, as early intervention can help delay disease progression. Studies have shown that ART can reduce HIV transmission to sexual partners by up to 96%. Conditions such as pregnancy and Hepatitis B and C increase the need to initiate therapy sooner and are in no way contraindicated. ART does not cure HIV, but to maintain viral suppression, it should be continued indefinitely.
Which of the following diseases or conditions is least likely to be associated with increased potential for bleeding?
- A. metastatic liver cancer
- B. gram-negative septicemia
- C. pernicious anemia
- D. iron-deficiency anemia
Correct Answer: C
Rationale: Pernicious anemia results from vitamin B12 deficiency due to lack of intrinsic factor. This can result from inadequate dietary intake, faulty absorption from the GI tract due to a lack of secretion of intrinsic factor normally produced by gastric mucosal cells and certain disorders of the small intestine that impair absorption. The nurse should instruct the client in the need for lifelong replacement of vitamin B12, as well as the need for folic acid, rest, diet, and support.