Nokea
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.
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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.
Which of the following would likely not be a barrier to learning?
- A. a client who took Ambien an hour ago
- B. a bipolar client currently in a manic phase
- C. a client who states they are not interested
- D. a client with dysphagia
Correct Answer: D
Rationale: Dysphagia may be a barrier to communication but not to learning. Barriers to learning include an altered mental status, taking sedative medications, and lack of motivation to learn.
The client undergoing detoxification from chronic alcohol abuse is to receive Phenobarbital 120 mg IM and promethazine 50 mg IM. Which explanation by the nurse about using this medication combination is correct?
- A. Promethazine will prevent a potential allergic reaction to the phenobarbital.
- B. Combining promethazine and phenobarbital will have a greater sedative effect.
- C. Promethazine will decrease the nausea from phenobarbital when it is given IM.
- D. Combining these reduces the sedative effects and prevents a ‘hangover' feeling.
Correct Answer: B
Rationale: Promethazine (Phenergan) potentiates the CNS depression of phenobarbital, producing a greater sedative effect.
The LPN is teaching a 25-year-old client about HPV. Which statements made by the client indicate understanding of the teaching? Select all that apply.
- A. I can only get HPV if my boyfriend has symptoms.
- B. HPV can cause cancers later in life, which is why it is important to prevent it now.
- C. I feel a bit better about having HPV now that I know that almost all sexually active people have it at some point.
- D. It's a bummer that I'm too old for the vaccine.
- E. If I take my birth control diligently, I can significantly reduce my risk for HPV.
Correct Answer: B
Rationale: HPV infection is common and most adults will have HPV at some point in their life. It can be transmitted via skin-to-skin contact as well through vaginal, anal, or oral sex. HPV infections can cause cancer, though most infections will disappear within two years. Transmission of HPV can occur even if someone is not symptomatic of infection. The HPV vaccine is recommended for children age 9 up to adults age 26. The only way to help prevent sexual transmission of HPV between partners is with condom use.
Cyclosporine and methotrexate are prescribed for the client with severe rheumatoid arthritis. What information should the nurse address when teaching the client? Select all that apply.
- A. Drink grapefruit juice to enhance the medication effects.
- B. Drink plenty of fluids to prevent becoming dehydrated.
- C. Avoid use of St. John's wort, echinacea, and melatonin.
- D. These medications are administered weekly by injection.
- E. Methotrexate and cyclosporine suppress the immune system.
Correct Answer: B,C,E
Rationale: A: Grapefruit juice should be avoided because it can increase the concentration of cyclosporine. B: Adequate hydration minimizes the risk of adverse effects. C: St. John's wort decreases cyclosporine levels. Echinacea and melatonin interact with cyclosporine to alter immunosuppression. D: Methotrexate and cyclosporine can be taken orally instead of by injection. It is incorrect that both medications are taken weekly. Only methotrexate is taken weekly, whereas cyclosporine is usually taken twice daily. E: Methotrexate and cyclosporine both have immunosuppressive effects.