Nokea
The client taking paroxetine telephones the mental health clinic nurse and states, “Since I started taking St. John's wort, I have had a high fever and muscle stiffness, and I am sweating a lot.†Which statement is most appropriate?
- A. You may have the flu; call your primary provider to make an appointment.
- B. Take ibuprofen, drink fluids, and rest; call tomorrow if the symptoms worsen.
- C. Could you have doubled up on your medication, taking more than prescribed?
- D. You should be taken to the emergency department right away to be evaluated.
Correct Answer: D
Rationale: Fever, muscle stiffness (rigidity), and diaphoresis are symptoms of serotonin syndrome, a potentially fatal condition that may occur with concurrent use of St. John's wort and paroxetine (Paxil). The client should be taken to the ED.
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The parent of the 2-year-old with asthma has been given instructions about asthma control and Step Therapy. Which statement, if made by the parent, should indicate to the nurse that the parent has an adequate understanding of the instructions?
- A. If my child has wheezing twice a week or less, I should add the nebulized corticosteroid and make an appointment.
- B. If my child has a respiratory tract infection I should add the nebulized corticosteroid and make an appointment.
- C. If my child has to use the nebulizer less than twice a week, I should add the nebulized corticosteroid and make an appointment.
- D. If my child has nighttime awakenings with wheezing twice a month or more, I should add the nebulized corticosteroid and make an appointment.
Correct Answer: D
Rationale: A: Asthma symptoms (wheezing) occurring 2 or fewer days per week should be treated at Step 1. B: A respiratory tract infection may require the increased use of short-acting beta agonists, but an inhaled corticosteroid should not be added until the child is evaluated by the HCP. C: The use of the nebulizer twice a week or less should be treated at Step 1. D: Nighttime waking with asthma symptoms 1 to 2 times per month indicates the need to proceed to Step 2 therapy, which includes the use of an inhaled corticosteroid.
Which type of hepatitis is transmitted via the fecal-oral route?
- A. A
- B. B
- C. C
- D. D
Correct Answer: A
Rationale: Hepatitis A is transmitted via the fecal-oral route, often through contaminated food or water, unlike B, C, and D, which are primarily bloodborne.
The HCP's progress notes state a plan to initiate an oral NSAID for the child's pain. Based on this information, the nurse should consult with the HCP when noting that which medication was the only analgesic prescribed?
- A. Naproxen
- B. Tolmetin
- C. Ibuprofen
- D. Hydromorphone
Correct Answer: D
Rationale: A: Naproxen (Aleve) is an NSAID. B: Tolmetin (Tolectin) is an NSAID. C: Ibuprofen (Advil, Motrin) is an NSAID. D: Hydromorphone (Dilaudid) is an opioid analgesic, not an NSAID.
The HCP prescribes amoxicillin for the 8-month-old with acute otitis media that has not resolved. Which statement to the parents is correct regarding the primary purpose of amoxicillin?
- A. It will reduce the child's fever.
- B. It will reduce the child's severe ear pain.
- C. It will shrink swollen tissue in the Eustachian tube.
- D. It will treat the probable organism, Haemophilus influenzae.
Correct Answer: D
Rationale: A: As the infection is treated, the fever will be reduced, but this is not the primary reason for treatment with amoxicillin. B: Treating the ear infection will reduce the pain, but that is not the primary purpose for treatment with amoxicillin. C: Reducing inflammation of the eustachian tube will occur, but this is not the primary purpose for treatment with amoxicillin. D: Acute otitis media is frequently caused by the Haemophilus influenzae and Streptococcus pneumoniae bacteria. The primary purpose of amoxicillin (Amoxil) is to treat the infection caused by these two organisms.
The nurse is assessing a client who has recently found out she is pregnant. Which of the following statements would be a priority for the nurse to follow up on?
- A. I am nervous about how painful labor will be.
- B. I need to review my finances and make sure I am prepared to care for a child.
- C. I hate this nausea that I've been having for a week.
- D. I am preparing myself to do this on my own because I do not have any family nearby. But I have always been very independent.
Correct Answer: D
Rationale: The nurse should follow up on the client's lack of support system. Even if there is no family in the area, there are supportive resources in the community that may help the client through the pregnancy and into motherhood. It is normal for the client to worry about labor, address financial concerns, and express displeasure from early pregnancy symptoms such as nausea.