Nokea
Melissa Smith came to the Emergency Department in the last week before her estimated date of confinement complaining of headaches, blurred vision, and vomiting. Suspecting PIH, the nurse should best respond to Melissa's complaints with which of the following statements?
- A. The physician will probably want to admit you for observation.'
- B. The physician will probably order bed rest at home.'
- C. These are really dangerous signs.'
- D. The physician will probably prescribe some medicine for you.'
Correct Answer: B
Rationale: Pregnancy-induced hypertension (PIH) symptoms like headaches, blurred vision, and vomiting suggest preeclampsia, which is best managed with bed rest at home unless severe, requiring hospitalization.
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The adolescent is brought to the ED with wheezing, nystagmus, ataxia, and sensorimotor neuropathy after inhaling paint thinner by “bagging.†Which nursing intervention is priority?
- A. Monitor the client's cardiac rhythm.
- B. Place the client on seizure precautions.
- C. Apply oxygen via nasal cannula at 4 liters.
- D. Notify lab to obtain a toxicology screen.
Correct Answer: C
Rationale: Applying oxygen is the priority to address wheezing and potential oxygen displacement from inhalant use.
The clinic nurse is reviewing prescriptions with the parents of the school-aged child with newly diagnosed generalized contact dermatitis. Which prescription should the nurse question with the HCP?
- A. Oral prednisone
- B. Calamine lotion
- C. Oral diphenhydramine
- D. Hydrocortisone cream
Correct Answer: A
Rationale: A: Prednisone (Deltasone) would not be a first-line treatment for contact dermatitis, and its use should be questioned. Prednisone may be added later if the contact dermatitis has not resolved. B: Calamine lotion is used to promote drying and help relieve itching. C: Diphenhydramine (Benadryl) helps to relieve itching. D: Hydrocortisone cream is an anti-inflammatory agent used to treat contact dermatitis.
The client is prescribed medications on hospital admission. Four days later the client's serum creatinine level, which was normal at admission, is now 3.7 mg/dL. The nurse should contact the HCP regarding a dosage change for which medication?
- A. Ceftriaxone
- B. Insulin glargine
- C. Diltiazem
- D. Furosemide
Correct Answer: A
Rationale: A: The nurse should contact the HCP regarding ceftriaxone (Rocephin). Ceftriaxone, a third-generation cephalosporin antibiotic, is 33% to 67% excreted in the urine unchanged. Dosage reduction or increased dosing interval is recommended in renal insufficiency because ceftriaxone is nephrotoxic and can further damage the kidneys. B: Insulin glargine (Lantus) is partially metabolized at the site of injection to active insulin metabolites and partially metabolized by the liver, the spleen, the kidney, and muscle tissue; no dose reduction is necessary unless serum glucose levels fluctuate. C: Diltiazem (Cardizem) is mostly metabolized by the liver; no dose reduction is necessary. D: Furosemide (Lasix) is 30% to 40% metabolized by the liver with some nonhepatic metabolism and renal excretion as unchanged medication; no dose reduction is necessary.
The client has been on vancomycin for three days. Which of the following symptoms is least concerning?
- A. nausea
- B. headache
- C. vertigo
- D. tinnitus
Correct Answer: B
Rationale: Vancomycin can cause ototoxicity, and tinnitus, vertigo, and nausea are symptoms of this condition. Headache is not typically associated with vancomycin's side effects.
The nurse is working with the family whose child is taking atomoxetine for ADHD. Which instructions should the nurse include when teaching the parents? Select all that apply.
- A. Provide stimulation because atomoxetine causes sedation.
- B. Administer atomoxetine immediately after eating a meal.
- C. Administer atomoxetine at least 6 hours before bedtime.
- D. Weigh the child weekly to monitor for unintended weight loss.
- E. Consult with the prescriber before giving cold or allergy medication.
Correct Answer: B,C,D,E
Rationale: Atomoxetine (Strattera) should be taken after meals, at least 6 hours before bedtime, with weekly weight monitoring and caution with OTC medications.