Nokea
The client with thick, crusty, yellow toenails is diagnosed with tinea unguium (onychomycosis) and asks the clinic nurse what happens if he can’t afford to take the medication the physician prescribed. The nurse’s response will be based on which scientific rationale?
- A. The toes will become gangrenous and may have to be amputated.
- B. Over-the-counter antifungal creams can be substituted for the oral medication.
- C. The toenail plate will separate and the entire toenail may be destroyed.
- D. Take all the prescribed antibiotics or the infection may return.
Correct Answer: C
Rationale: Untreated onychomycosis can destroy the toenail plate, causing separation. Gangrene is unlikely, OTC creams are less effective, and antibiotics are irrelevant.
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Cimetidine [Tagamet] is ordered IV every six hours for a person with severe burns. What is the primary reason for administering Tagamet to this client?
- A. To prevent infection
- B. To restore electrolyte balance
- C. To promote renal function
- D. To prevent Curling's ulcers
Correct Answer: D
Rationale: Cimetidine is used to prevent Curling’s ulcers, stress-induced gastric ulcers common in severe burn clients due to increased gastric acid production.
Postoperatively, which of the following client concerns should be the nurse's highest priority?
- A. Pain
- B. Waiting
- C. Anxiety
- D. Fatigue
Correct Answer: A
Rationale: Pain is a priority as it may indicate complications like infection or graft failure.
Which nursing intervention is most appropriate to add to the care plan to reduce the client's anxiety?
- A. Let the client suggest ways to carry out care.
- B. Discontinue nursing care measures at this time.
- C. Restrict care to nutrition and elimination only.
- D. Carry out nursing activities quickly and efficiently.
Correct Answer: A
Rationale: Involving the client in care decisions reduces anxiety by providing control.
The elderly client diagnosed with poison ivy is prescribed a Solu-Medrol (a steroid) dose pack. Which intervention should the nurse teach the client?
- A. Tell the client to return to the office in one (1) week for blood levels.
- B. Instruct the client to take the medication exactly as prescribed.
- C. Explain the medication should be taken on an empty stomach.
- D. Teach to stop the medication immediately if side effects occur.
Correct Answer: B
Rationale: Taking steroids as prescribed ensures efficacy and minimizes risks. Blood levels are unnecessary, food reduces GI upset, and abrupt stopping is harmful.
After reviewing the medical orders, which of the following is essential for the nurse to assess preoperatively?
- A. The client's face for skin lesions
- B. The client of the last dose of anticoagulant
- C. The client's right eye for drainage
- D. The client's left eye for signs of strain
Correct Answer: B
Rationale: Assessing the last anticoagulant dose is critical to prevent bleeding during surgery.