Nokea
Mr. Lee comes to the clinic with thick green drainage around his eyelids. The nurse examiner takes his history and performs a physical examination, beginning with an eye history. General information the nurse should seek is:
- A. type of employment.
- B. burning or itchy sensation in the eyes.
- C. position of the eyelids.
- D. existence of floaters.
Correct Answer: A
Rationale: Data belonging in a general health history of the eye includes employment, activities, allergies, medications, lenses, and protective devices used.
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A patient has recently been prescribed Zidovudine (Retrovir). The patient has AIDS. Which of the following side effects should the patient specifically watch out for?
- A. Weakness and SOB
- B. Fever and anemia
- C. Hypertension and SOB
- D. Fever and hypertension
Correct Answer: B
Rationale: Anemia and fever are associated with Zidovudine's side effects.
A client needs to rapidly achieve a therapeutic plasma drug concentration of a medication. Rather than wait for steady state to be achieved, the physician might order:
- A. a maintenance dose.
- B. a loading dose.
- C. a medication with no first-pass effect.
- D. the medication to be given intravenously.
Correct Answer: B
Rationale: A loading or priming dose rapidly establishes a therapeutic plasma drug level. It can be calculated by multiplying the volume of distribution by the desired plasma drug concentration.
In infants and children, the side effects of first-generation over-the-counter (OTC) antihistamines, such as diphenhydramine (Benedryl) and hydroxyzine (Atarax), can include:
- A. Reye's syndrome.
- B. cholinergic effects.
- C. paradoxical CNS stimulation.
- D. nausea and diarrhea.
Correct Answer: C
Rationale: Typically, first-generation OTC antihistamines have a sedating effect because of passage into the CNS. However, in some individuals, especially infants and children, paradoxical CNS stimulation occurs and is manifested by excitement, euphoria, restlessness, and confusion. For this reason, use of first-generation OTC antihistamines has declined and second-generation product use has increased. Reye's syndrome is a systemic response to a virus. First-generation OTC antihistamines do not exhibit a cholinergic effect. Nausea and diarrhea are uncommon with first-generation OTC antihistamines.
A teenage client is admitted to the hospital because of acetaminophen (Tylenol) overdose. Overdoses of acetaminophen can precipitate life-threatening abnormalities in which of the following organs?
- A. lungs
- B. liver
- C. kidneys
- D. adrenal glands
Correct Answer: B
Rationale: Acetaminophen is extensively metabolized in the liver. Choices A, C, and D are incorrect because prolonged use of acetaminophen might result in an increased risk of renal dysfunction, but a single overdose does not precipitate life-threatening problems in the respiratory system, renal system, or adrenal glands.
The nurse is caring for a postpartum woman who has relinquished her baby for adoption. The care plan for the client should include which of the following priority strategies?
- A. Make a referral for grief counseling
- B. Allow the woman to see her baby initially, and then discourage further visits
- C. Provide opportunities for the woman to express her feelings
- D. Inform the woman she has the right to change her mind about relinquishment
Correct Answer: C
Rationale: Providing opportunities to express feelings addresses the immediate emotional needs of grief, loneliness, and guilt, which is a priority for supporting the woman's psychological well-being.