Nokea
If a client who has recently experienced diminished hearing takes medications from each of the following drug categories, which one is most likely to have affected the client's hearing?
- A. Nonsteroidal anti-inflammatory drug
- B. Beta-adrenergic blocker
- C. Aminoglycoside antibiotic
- D. Histamine-2 (H2) antagonist
Correct Answer: C
Rationale: Aminoglycosides are ototoxic and can cause hearing loss.
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The nurse is preparing the plan of care for a client diagnosed with Stevens-Johnson syndrome. Which interventions should the nurse include? Select all that apply.
- A. Monitor intake and output every eight (8) hours.
- B. Assess breath sounds and rate every four (4) hours.
- C. Assess vesicles, erosions, and crusts frequently.
- D. Perform the whisper test for auditory changes daily.
- E. Assess orientation to person, place, and time every shift.
Correct Answer: A,B,C,E
Rationale: Monitoring I&O, breath sounds, skin lesions, and orientation address SJS complications (fluid loss, respiratory issues, skin breakdown, neurological changes). Whisper test is irrelevant.
The ED nurse is caring for a client admitted with extensive, deep partial-thickness and full-thickness burns. Which interventions should the nurse implement? List in order of priority.
- A. Estimate the amount of burned area using the rule of nines.
- B. Insert two (2) 18-gauge catheters and begin fluid replacement.
- C. Apply sterile saline dressings to the burned areas.
- D. Determine the client’s airway status.
- E. Administer morphine sulfate, IV.
Correct Answer: D,B,E,A,C
Rationale: Priority: 1) Airway status (ABCs); 2) IV catheters/fluids (prevent shock); 3) Morphine (pain control); 4) Rule of nines (guide resuscitation); 5) Sterile dressings (infection prevention).
If a client with a middle ear infection reports the following symptoms, which one suggests that the infection has spread to the inner ear?
- A. Temporal headaches
- B. A sore throat
- C. Nasal congestion
- D. Postural dizziness
Correct Answer: D
Rationale: Postural dizziness suggests inner ear involvement, such as labyrinthitis.
The client is diagnosed with herpes simplex 2 and prescribed the antiviral medication valacyclovir (Valtrex). Which instructions should the nurse teach?
- A. This medication will prevent pregnancy and treat the virus.
- B. This medication must be tapered when discontinuing the medication.
- C. This medication will suppress symptoms but does not cure the disease.
- D. This medication may cause the client’s urine to turn orange.
Correct Answer: C
Rationale: Valacyclovir suppresses HSV-2 symptoms but does not cure it. It does not prevent pregnancy, require tapering, or change urine color.
While the nurse is assessing the client hospitalized with recurrent lower-extremity cellulitis, the client states, 'I have athlete's foot; do you want to check it?' The nurse concludes that this information is significant for what reason?
- A. Cellulitis is commonly caused by a similar fungal infection.
- B. Both infections should resolve with topical fungicide therapy.
- C. Painful neuralgia can occur after the cellulitis infection has resolved.
- D. The skin disruption with tinea pedis may be the cause of the cellulitis.
Correct Answer: D
Rationale: Cellulitis is an infection with diffuse inflammation occurring in the tissue just under the skin. Chronic athlete's foot causes minute breaks in the skin, allowing bacteria on the skin to enter the tissue and cause the infectious process. Cellulitis is caused by a bacterial infection, not fungal. Cellulitis requires antibiotics, not fungicides. Neuralgia is associated with herpes zoster, not cellulitis.