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For a client with suspected appendicitis, the nurse should expect to find abdominal tenderness in which quadrant?
- A. upper right
- B. upper left
- C. lower right
- D. lower left
Correct Answer: C
Rationale: The nurse should expect to find abdominal tenderness in the lower-right quadrant in a client with appendicitis.
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Which of the following should not be included in the teaching for clients who take oral iron preparations?
- A. Mix the liquid iron preparation with antacids to reduce GI distress
- B. Take the iron with meals if GI distress occurs
- C. Liquid forms should be taken with a straw to avoid discoloration of tooth enamel
- D. Oral forms should be taken with juice, not milk
Correct Answer: A
Rationale: Iron should not be mixed with antacids, as antacids can reduce iron absorption. The other options are appropriate: taking with meals can reduce GI distress, using a straw prevents tooth discoloration, and juice enhances absorption while milk can inhibit it.
The client with GERD is taking cimetidine. Which serum laboratory finding should the nurse determine is most concerning?
- A. Increased liver enzymes
- B. Increased platelet count
- C. Decreased creatinine
- D. Decreased prolactin
Correct Answer: A
Rationale: A: Elevation of liver enzymes should be most concerning because drug-induced hepatitis is an adverse effect of cimetidine (Tagamet HB) therapy. B: Histamine-2 receptor blockers can cause myelosuppression including thrombocytopenia. A decreased (not increased) platelet count would be concerning. C: Renal adverse effects of the drug include elevated (not decreased) creatinine and BUN. D: Cimetidine can increase (not decrease) secretion of prolactin from the anterior pituitary, inducing gynecomastia.
The initial treatment regimen of isoniazid, rifampin, and ethambutol is prescribed for the adolescent who has a positive tuberculin skin test. The client confides that she thinks she may be pregnant and asks if she should be taking these medications. Which rationale should be the basis for the nurse's response?
- A. These drugs cross the placental barrier, and treatment should be withheld until the postpartum period.
- B. The medications should be taken, but the diagnosis is an indication for termination of the pregnancy.
- C. The medications should be postponed because the risk for hepatitis is greatly increased in the intrapartum period.
- D. The medications should be taken; untreated TB represents a far greater hazard to the pregnant woman and her fetus.
Correct Answer: D
Rationale: A: The medications do not cross the placental barrier, so treatment should not be withheld. B: Administering antituberculosis medications would not be an indication for termination of pregnancy because the medications are safe during pregnancy. C: The risk of hepatitis is slightly increased with the use of antituberculosis medications in pregnant women; however, the benefits of treatment strongly outweigh postponement of treatment. D: Infants born to women with untreated TB may be of lower birth weight, but rarely would the infant acquire congenital TB. Isoniazid (Nydrazid), rifampin (Rifadin), and ethambutol (Myambutol) are all considered safe for use in pregnancy.
The LPN is taking care of a client with a documented allergy to Penicillin. After rounds, the PN notices that the client has an order for Cefazolin. Which of the following actions would be the least appropriate?
- A. The LPN clarifies the severity of the Penicillin allergy.
- B. The LPN discusses the order with the care team prior to administering Cefazolin.
- C. The LPN administers all ordered medications except for the Cefazolin.
- D. The LPN monitors the client after a test dose of Cefazolin is administered.
Correct Answer: C
Rationale: The LPN should clarify the order with the care team prior to determining the medication should not be given. Even though the client may have a potential reaction due to the Penicillin allergy, the therapeutic benefits of the antibiotic may outweigh the allergic reaction.
Which of the following of Erikson's developmental stages are relevant to adults ages 18-64? Select all that apply.
- A. Ego Integrity vs. Despair
- B. Generativity vs. Stagnation
- C. Industry vs. Inferiority
- D. Initiative vs. Guilt
- E. Intimacy vs. Isolation
Correct Answer: A
Rationale: In the adult 18-64 stage, Intimacy vs. Isolation is relevant to young adulthood and Generativity vs. Stagnation is relevant to middle adulthood. Initiative vs. Guilt is relevant to preschool childhood. Industry vs. Inferiority is relevant to school-age childhood. Ego Integrity vs. Despair is relevant to mature adulthood after age 65.