Nokea
The child with seizure disorder is being treated with phenytoin (Dilantin). Which of the following statements by the patient's mother indicates to the nurse that the patient is experiencing a side effect of Dilantin therapy?
- A. She is very irritable lately.'
- B. She sleeps quite a bit of the time.'
- C. Her gums look too big for her teeth.'
- D. She has gained about 10 pounds in the last six months.'
Correct Answer: C
Rationale: Gingival hyperplasia (overgrown gums) is a common side effect of phenytoin (Dilantin). Irritability, excessive sleep, and weight gain are not typical side effects of this medication.
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The nurse is caring for a client with a diagnosis of preterm labor. Which medication is most likely to be ordered?
- A. Betamethasone
- B. Terbutaline
- C. Magnesium sulfate
- D. All of the above
Correct Answer: D
Rationale: Betamethasone promotes fetal lung maturity terbutaline and magnesium sulfate are tocolytics to halt preterm contractions and magnesium may also provide neuroprotection. All are commonly ordered in preterm labor.
When discussing the relationship between exercise and insulin requirements, a 26-year-old client with IDDM should be instructed that:
- A. When exercise is increased, insulin needs are increased
- B. When exercise is increased, insulin needs are decreased
- C. When exercise is increased, there is no change in insulin needs
- D. When exercise is decreased, insulin needs are decreased
Correct Answer: B
Rationale: Exercise decreased the blood sugar by promoting uptake of glucose by the muscles. Consequently, less insulin is needed to metabolize ingested carbohydrates. Extra food may be required for extra activity.
The nurse caring for a client with a closed head injury obtains an intracranial pressure (ICP) reading of 17 mmHg. The nurse recognizes that:
- A. The ICP is elevated and the doctor should be notified.
- B. The ICP is normal; therefore, no further action is needed.
- C. The ICP is low and the client needs additional IV fluids.
- D. The ICP reading is not as reliable as the Glasgow coma scale.
Correct Answer: A
Rationale: Normal ICP is 5-15 mmHg. A reading of 17 mmHg is elevated, indicating potential brain swelling, and requires immediate notification of the physician. The Glasgow scale complements but does not replace ICP monitoring.
Which of the following is an expected finding in a child with osteogenesis imperfecta?
- A. Blue sclera
- B. Hutchinson's teeth
- C. Anisocoria
- D. Pectus excavatum
Correct Answer: A
Rationale: Blue sclera is a hallmark of osteogenesis imperfecta due to thin connective tissue in the eyes. Hutchinson’s teeth are associated with congenital syphilis anisocoria is unequal pupil size and pectus excavatum is a chest deformity not specific to this condition.
The client with a recent liver transplant asks the nurse how long he will have to take an immunosuppressant. Which response is correct?
- A. One year
- B. Five years
- C. 10 years
- D. Life
Correct Answer: D
Rationale: Liver transplant recipients require lifelong immunosuppression to prevent graft rejection, as the immune system continuously recognizes the transplant as foreign.