Nokea
The client has been newly diagnosed with epilepsy. Which discharge instructions should be taught to the client? Select all that apply.
- A. Keep a record of seizure activity.
- B. Take tub baths only; do not take showers.
- C. Avoid over-the-counter medications.
- D. Have anticonvulsant medication serum levels checked regularly.
- E. Do not drive alone; have someone in the car.
Correct Answer: A,C,D,E
Rationale: Recording seizures (A) helps track treatment efficacy, avoiding OTC medications (C) prevents interactions, regular serum levels (D) ensure therapeutic dosing, and not driving alone (E) ensures safety. Tub baths (B) pose a drowning risk and are not advised.
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The client comes to the clinic for treatment of a dog bite. Which intervention should the clinic nurse implement first?
- A. Prepare the client for a series of rabies injections.
- B. Notify the local animal control shelter.
- C. Administer a tetanus toxoid in the deltoid.
- D. Determine if the animal has had its vaccinations.
Correct Answer: D
Rationale: Determining the animal’s vaccination status (D) is the first step to assess rabies risk, guiding further interventions. Rabies injections (A) are premature, animal control (B) is secondary, and tetanus (C) follows risk assessment.
Which instruction should the nurse include for a client taking phenytoin (Dilantin)?
- A. Brush teeth gently to prevent gum hyperplasia.
- B. Avoid grapefruit juice.
- C. Take the medication with milk.
- D. Increase dietary sodium intake.
Correct Answer: A
Rationale: Phenytoin can cause gingival hyperplasia; gentle brushing helps prevent gum complications.
Which response by the nurse would be best to prevent distress when the client repeatedly asks, 'Where is my mother?'
- A. Explain to the client, 'Your mother died several years ago.'
- B. Tell the client, 'Your mother will visit later.'
- C. State, 'You miss your mother. What was she like?'
- D. Ask the client, 'When did you last see your mother?'
Correct Answer: C
Rationale: Redirecting the conversation to memories of the mother validates the client's feelings without causing distress from confronting reality.
The client is reporting neck pain, fever, and a headache. The nurse elicits a positive Kernig's sign. Which diagnostic test procedure should the nurse anticipate the HCP ordering to confirm a diagnosis?
- A. A computed tomography (CT).
- B. Blood cultures times two (2).
- C. Electromyogram (EMG).
- D. Lumbar puncture (LP).
Correct Answer: D
Rationale: Neck pain, fever, headache, and positive Kernig’s sign suggest meningitis. A lumbar puncture (D) confirms the diagnosis via CSF analysis. CT (A) may precede LP, blood cultures (B) are supportive, and EMG (C) is unrelated.
When implementing seizure precautions, which nursing action is most appropriate?
- A. Move the client to a room closer to the nurses' station.
- B. Serve the client's food in paper and plastic containers.
- C. Maintain the client's bed in the lowest position.
- D. Ensure that soft limb restraints are applied to upper extremities.
Correct Answer: C
Rationale: Maintaining the bed in the lowest position minimizes the risk of injury from falls during a seizure.