Nokea
The client with Addison's disease is taking fludrocortisone 100 mcg orally once daily. Which statement made by the client regarding the fludrocortisone therapy requires further teaching by the nurse?
- A. I should talk to my health care provider about getting a flu shot this year.
- B. I should stop taking fludrocortisone if my blood sugar levels are too high.
- C. I should check my weight, blood pressure, and pulse once every morning.
- D. I should eat foods higher in potassium like bananas, melons, and pears.
Correct Answer: B
Rationale: A: The client should check with the HCP about getting vaccinations such as influenza; a chronic condition increases the client's risk for other illnesses and complications. B: The client needs further teaching if stating that he or she will stop taking fludrocortisone (Florinef) if his or her blood sugar levels are too high; stopping mineralocorticoid replacement therapy abruptly may lead to addisonian crisis. C: Common adverse effects of fludrocortisone include edema, arrhythmias, and hypertension; stating that he or she should monitor weight, BP, and pulse daily is appropriate. D: Common adverse effects of fludrocortisone include hypokalemia; stating that he or she should consume potassium-rich foods is appropriate.
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Which of the following actions should the LPN perform for a client with an active digoxin IV order? Select all that apply. A. Monitor ECG rhythm throughout administration., B. Administer the medication over at least 5 minutes., C. Monitor respirations during administration., D. Monitor the client's pulse for 1 minute prior to administration., E. Assess the client's blood pressure.
- A. A, D
- B. A, B, D
- C. B, C
- D. A, D, E
Correct Answer: A
Rationale: The LPN should monitor the client's heart rate and ECG with digoxin administration. Digoxin should not be given if a client's pulse is less than 60 bpm. Measuring blood pressure and respiratory rate are not indicated with digoxin administration. Administering an IV medication is outside of the LPN's scope of practice.
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 of the following medications is a serotonin antagonist that might be used to relieve nausea and vomiting?
- A. metoclopramide (Reglan)
- B. onedansetron (Zofran)
- C. hydroxyzine (Vistaril)
- D. prochlorperazine (Compazine)
Correct Answer: B
Rationale: Zofran is a serotonin antagonist that can be used to relieve nausea and vomiting. The other medications can be used for nausea and vomiting, but they have different mechanisms of action.
The child with CF is receiving albuterol. Which response should the nurse expect if albuterol is achieving the desired therapeutic effect?
- A. Increased heart rate
- B. Improved weight gain
- C. Fewer hospitalizations
- D. Fewer adventitious lung sounds
Correct Answer: D
Rationale: A: Albuterol may increase HR, but this is not the desired therapeutic effect. B: Weight should not be affected by albuterol. C: The use of a bronchodilator has not been demonstrated to decrease hospitalization frequency. D: The desired therapeutic effect of a bronchodilator such as albuterol (Proventil) is a reduction in adventitious (abnormal) breath sounds.
The nurse is teaching the parent of the 3-year-old being treated with vincristine sulfate for Wilms' tumor. The nurse should inform the parents to immediately notify the HCP of which most significant adverse effect?
- A. The child develops diarrhea.
- B. The child's hair begins to fall out.
- C. The child develops dysphagia and paresthesia.
- D. The child has signs or symptoms of depression.
Correct Answer: C
Rationale: A: Both diarrhea and severe constipation are adverse effects of vincristine, and prophylactic treatment is implemented at the beginning of therapy to decrease the potential of these occurring. B: Hair loss is a common adverse reaction to the medication and is reversible. C: Dysphagia and paresthesia are CNS adverse effects from vincristine sulfate (Oncovin). The nurse should teach the parent to notify the HCP immediately if these occur. D: Three-year-olds may not show signs or symptoms of depression. If present, the signs and symptoms should be distinguished as being associated with the neoplastic disease itself or as side effects of the medication.