Nokea
The client seeking treatment for insomnia tells the nurse about researching complementary therapies for promoting sleep. Which are herbal remedies for promoting sleep that the client may wish to discuss with the nurse?
- A. Fennel and ginger tea
- B. Chamomile tea and hops
- C. Feverfew and peppermint
- D. Echinacea and goldenseal
Correct Answer: B
Rationale: Chamomile tea and hops are believed to relieve insomnia.
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The nurse has completed swaddling the 2-month-old infant, prepared supplies to cannulate the scalp vein for an IV infusion, and cleansed and shaved the hair at the site over the temporal bone. Place the remaining steps in the order that they should be performed by the nurse.
- A. Return in 60 minutes and reswaddle the infant in a mummy restraint.
- B. With an assistant holding the infant's head, insert a scalp vein needle and observe for blood return.
- C. Apply lidocaine/prilocaine cream to the site selected and unswaddle the infant after the cream application.
- D. Cleanse the shaved area with an antiseptic solution.
- E. Remove the mummy restraint after initiating the infusion and comfort the infant.
- F. Initiate the infusion and cover the infusion needle with a gauze dressing.
Correct Answer: C,A,D,B,F,E
Rationale: C: Apply lidocaine/prilocaine (EMLA) cream to the site selected and unswaddle the infant after the cream application. An anesthetic cream will numb the site and help reduce the infant's pain during insertion. The infant does not need to remain swaddled while the cream reaches its therapeutic effectiveness in about an hour. A: Return in 60 minutes and reswaddle the infant in a mummy restraint. It takes about an hour for the lidocaine/prilocaine cream to reach its therapeutic effectiveness. The infant should be reswaddled to minimize movement during insertion. D: Cleanse the shaved area with an antiseptic solution. Cleansing the area with an antiseptic solution will help prevent inadvertent introduction of microorganisms into the vascular system. B: With an assistant holding the infant's head, insert a scalp vein needle and observe for blood return. Movement of the infant's head can result in loss of the vein access or a needle-stick injury to the infant or nurse. F: Initiate the infusion and cover the infusion needle with a gauze dressing. Once the vein has been successfully cannulated, the site can be dressed and IV fluids started. E: Remove the mummy restraint after initiating the infusion and comfort the infant. The mummy restraint is no longer needed after the IV catheter has been successfully inserted into a scalp vein.
The nurse is developing a teaching plan for the client prescribed nortriptyline. Which self-care aspects should be included to minimize medication side effects and prevent injury? Select all that apply.
- A. Avoid eating processed meats, cheeses, and wines.
- B. Suck on candy or ice chips to keep your mouth moist.
- C. Run water in the bathroom to stimulate urination if needed.
- D. Increase fluid and fiber in the diet to prevent constipation.
- E. Avoid driving until vision is completely clear to prevent injury.
- F. Increase exposure to sunlight to facilitate vitamin D absorption.
Correct Answer: B,C,D,E
Rationale: Nortriptyline (Pamelor) causes dry mouth, urinary retention, constipation, and blurred vision. Sucking on candy, running water to stimulate urination, increasing fluid and fiber, and avoiding driving until vision is clear are appropriate.
The LPN is preparing a client for discharge and the discharge medications include phenobarbital. Which of these client statements would indicate a need for reinforced teaching about this medication?
- A. I will need to avoid eating excessive leafy greens.
- B. It's best to take this medication with food.
- C. I can't wait to get back to my nightly glass of wine.
- D. I should try to take this medication at the same time every day.
Correct Answer: C
Rationale: Phenobarbital should not be taken with alcohol as it is a barbiturate. Alcohol may increase the sedative effect.
A 37-year-old female client asks the nurse about contraception options, and says she would like to ask her doctor for a prescription for an oral contraception pill. Which of the following statements would indicate that oral contraception is appropriate for this client?
- A. I quit smoking last year, but I started again recently. Maybe I'll try to quit later this year.
- B. I am very diligent at taking my thyroid medications at the same time every day.
- C. I was hospitalized for deep vein thrombosis five years ago.
- D. I was recently diagnosed with breast cancer.
Correct Answer: B
Rationale: The client's statement about medication diligence shows that this client could be compliant with a daily oral contraceptive. Contraindications to oral contraception include breast cancer, a history of deep vein thrombosis, and smoking if over age 35.
The best lab test to diagnose disseminated intravascular coagulation (DIC) is:
- A. platelet count
- B. protime (PT)
- C. partial thromboplastin time (PTT)
- D. D-dimer
Correct Answer: D
Rationale: The D-dimer test specifically detects fibrin degradation products, indicating DIC's characteristic clotting and fibrinolysis. Other tests are less specific.