Nokea
The health care provider has just prescribed tetracycline for an adolescent with acne vulgaris. The client takes oral contraceptive pills. The nurse should reinforce teaching about which topics? Select all that apply.
- A. Not taking tetracycline with dairy products
- B. Taking tetracycline at bedtime
- C. Taking tetracycline with food
- D. Using additional contraceptive techniques
- E. Using sunblock
Correct Answer: A,D,E
Rationale: Tetracycline binds to calcium in dairy, reducing absorption. It can reduce oral contraceptive efficacy, requiring backup methods. Photosensitivity necessitates sunblock. Taking with food or at bedtime is acceptable but not critical teaching.
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A client on the psychiatric unit does not get to the dining room to eat because she is continually washing her hands and doesn't finish until after lunch. What should be included in the nursing care plan?
- A. Give the client a choice between eating lunch and performing her ritual.
- B. Tell the client an hour before lunch so she can perform her ritual before lunch.
- C. Discuss the problem with the client and ask her why she washes her hands so long.
- D. Tell the client she cannot wash her hands at all if she is going to be late for lunch.
Correct Answer: B
Rationale: Advance notice allows the client with OCD to complete rituals before lunch, facilitating nutrition without confrontation. Choices, discussions, or bans are less effective.
The nurse is reinforcing teaching about ulcer prevention with a client newly diagnosed with peptic ulcer disease. Which of the following client statements indicate appropriate understanding of teaching? Select all that apply.
- A. I need to avoid taking medicines like ibuprofen without a prescription.
- B. I should avoid drinking excess coffee or cola.
- C. I should enroll in a smoking cessation program.
- D. I should reduce or eliminate my intake of alcoholic beverages.
- E. I will eliminate whole wheat foods, like breads and cereals, from my diet.
Correct Answer: A,B,C,D
Rationale: Avoiding NSAIDs (ibuprofen), excess coffee/cola, smoking, and alcohol reduces ulcer irritation and promotes healing. Whole wheat foods are beneficial for digestion and not contraindicated.
The nurse is caring for a 2 year-old who is being treated with chelation therapy, calcium disodium edetate, for lead poisoning. The nurse should be alert for which of the following side effects?
- A. Neurotoxicity
- B. Hepatomegaly
- C. Nephrotoxicity
- D. Ototoxicity
Correct Answer: C
Rationale: Nephrotoxicity. Nephrotoxicity is a common side effect of calcium disodium edetate, in addition to lead poisoning in general.
Which finding is commonly noted in the client with bladder cancer?
- A. Painless hematuria.
- B. Bladder spasms.
- C. Lower back pain.
- D. Urinary frequency.
Correct Answer: A
Rationale: Painless hematuria is a hallmark symptom of bladder cancer, often the earliest sign. Other symptoms may occur but are less specific.
The nurse is reviewing discharge instructions with a client going home on linezolid therapy for a vancomycin-resistant enterococcus infection. Which client statement requires further teaching?
- A. I can restart my paroxetine once I get back home.
- B. I can take acetaminophen for headaches.
- C. I will avoid foods and drinks that contain tyramine.
- D. I will report any increased fever or diarrhea.
Correct Answer: A
Rationale: Linezolid interacts with SSRIs like paroxetine, risking serotonin syndrome, requiring a washout period. Acetaminophen is safe, tyramine avoidance prevents hypertensive crises, and reporting fever/diarrhea monitors treatment response.