Nokea
Several clients have come to the emergency department after a possible bioterrorist act of arsenic overexposure. The nurse should assess these clients for which signs or symptoms immediately following the poisoning? Select all that apply.
- A. Violent vomiting.
- B. Severe diarrhea.
- C. Abdominal pain.
- D. Sensory neuropathy.
- E. Persistent cough.
Correct Answer: A,B,C
Rationale: Arsenic poisoning typically presents with acute gastrointestinal symptoms such as violent vomiting, severe diarrhea, and abdominal pain due to its toxic effects on the digestive system. Sensory neuropathy and persistent cough are less common immediate symptoms.
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Which of the following statements should indicate to the nurse that a client has understood the discharge instructions provided after her nasal surgery?
- A. I should not shower until my packing is removed.
- B. I will take stool softeners and modify my diet to prevent constipation.
- C. Coughing every 2 hours is important to prevent respiratory complications.
- D. It is important to blow my nose each day to remove the dried secretions.
Correct Answer: B
Rationale: Preventing constipation avoids straining, which could increaseSy to dislodge packing or cause bleeding. Showering is safe if precautions are taken. Coughing or nose-blowing could disrupt healing. The correct answer is based on preventing complications post-nasal surgery.
A nurse is educating a student nurse about blood transfusions. Which of the following statements by the student nurse indicates the need for additional teaching? Select all that apply.
- A. If a client should develop crackles in their lung fields, it is a sign of a hemolytic reaction.
- B. Transfusion-related graft versus host disease most commonly occurs in immuno-suppressed individuals.
- C. Transfusion-associated circulatory overload (TACO) is more common in clients with renal failure.
- D. It is important to ask the client about history of previous blood transfusions.
- E. Pre-medication with diphenhydramine and acetaminophen is always needed before transfusion.
Correct Answer: A,E
Rationale: Crackles in the lung fields indicate transfusion-associated circulatory overload (TACO), not a hemolytic reaction, which typically presents with fever, chills, and hemoglobinuria. Pre-medication with diphenhydramine and acetaminophen is not always required, only when prescribed for clients with a history of allergic reactions. The other statements are correct: graft versus host disease is common in immunosuppressed clients, TACO is more likely in renal failure, and transfusion history is important.
Ergotamine tartrate (Gynergen) is prescribed for a client's migraine headaches. The client's report of which of the following indicates effectiveness?
- A. Prevention of the migraine.
- B. Reduced severity of the developing migraine.
- C. Relief from the sleeplessness experienced in the past after a migraine.
- D. Relief from the vision problems experienced in the past after a migraine.
Correct Answer: B
Rationale: Ergotamine reduces the severity of developing migraines by constricting cranial blood vessels. It is not primarily preventive or used for post-migraine sleeplessness or vision issues.
A client with multiple sclerosis (MS) is receiving baclofen (Lioresal). The nurse determines that the drug is effective when it achieves which of the following?
- A. Induces sleep.
- B. Stimulates the client's appetite.
- C. Relieves muscular spasticity.
- D. Reduces the urine bacterial count.
Correct Answer: C
Rationale: Baclofen is a muscle relaxant used in MS to relieve spasticity, its primary therapeutic effect. It does not induce sleep, stimulate appetite, or reduce bacterial counts.
The nurse is teaching a client about a newly prescribed doxycycline. Which of the following statements, if made by the client, would require further teaching? Select all that apply.
- A. I should take this medication with milk or cheese.
- B. If I develop foul-smelling diarrhea I should contact my doctor.
- C. I need to wear sunscreen outdoors while taking this medication.
- D. I can stop this medication when I feel better.
- E. I should take this medication on an empty stomach.
Correct Answer: A,D
Rationale: Doxycycline should not be taken with dairy products like milk or cheese (Choice A) because calcium can bind to the medication and reduce its absorption. Choice D is incorrect because antibiotics like doxycycline should be taken for the full prescribed course to prevent resistance and ensure complete treatment. Choice B is correct; foul-smelling diarrhea could indicate a serious infection like Clostridium difficile. Choice C is correct; doxycycline causes photosensitivity, requiring sunscreen. Choice E is correct; taking doxycycline on an empty stomach improves absorption.