Nokea
The LPN is taking care of a client who is on Phenelzine (Nardil) for depression. Which meal would the nurse encourage the client to avoid?
- A. steak and potatoes
- B. prosciutto and cheese plate
- C. orange juice and toast
- D. carbonated water, shrimp and rice
Correct Answer: B
Rationale: Phenelzine (Nardil) is a type of MAOI (Monoamine Oxidase Inhibitor). Clients on these drugs should avoid foods and beverages with large amounts of tyramine, as they may cause dangerous elevations in blood pressure. Common foods high in tyramine include aged meats and cheeses, beer, sauerkraut, and soy sauce.
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The child with CF is prescribed vitamin A supplements. Which finding by the clinic nurse indicates that the vitamin has been effective?
- A. Skin is supple and healthy.
- B. Viscosity of secretions is decreased.
- C. Number of bleeding episodes is reduced.
- D. Pancreatic enzyme absorption is increased.
Correct Answer: A
Rationale: A: A water-miscible form of vitamin A is given in children diagnosed with CF because the uptake of the fat-soluble vitamins is decreased. One of the functions of vitamin A is to keep epithelial tissue healthy by aiding the differentiation of specialty cells. B: Other treatments for CF, such as bronchodilators and recombinant human deoxyribonuclease dornase alfa (Pulmozyme), decrease the viscosity of secretions. C: Vitamin K, another fat-soluble vitamin administered in CF, increases coagulation. D: Vitamin A has no effect on pancreatic enzyme absorption.
The test used to differentiate sickle cell trait from sickle cell disease is:
- A. sickle cell preparation
- B. peripheral smear
- C. sickledex
- D. hemoglobin electrophoresis
Correct Answer: D
Rationale: Hemoglobin electrophoresis identifies the specific hemoglobin types, distinguishing sickle cell trait (HbAS) from sickle cell disease (HbSS).
The child weighing 20 kg is to receive ceftriaxone 2 g IVPB q12h and dexamethasone 3 mg IV-push q6h for 4 days to treat Haemophilus influenzae type b meningitis. The drug reference states that the usual dose of ceftriaxone is 100 mg/kg/dose with a maximum daily dose of 4 g. The recommended dose of dexamethasone for treating H. influenzae type b meningitis is 0.15 mg/kg q6h for 2 to 4 days. Based on the medications prescribed and these findings, which conclusion by the nurse is correct?
- A. The dose of ceftriaxone is too high.
- B. The dose of dexamethasone is too low.
- C. Both medications are safe to administer as prescribed.
- D. The ceftriaxone should be given before the dexamethasone.
Correct Answer: C
Rationale: A: The dose for ceftriaxone is correct (100 mg x 20 kg = 2000 mg; 1000 mg = 1 g; 2000 mg = 2 g). B: The dose of dexamethasone is correct (0.15 mg x 20 kg = 3 mg). C: The doses of ceftriaxone (Rocephin) and dexamethasone (Decadron) are at the recommended doses. D: An IV-push medication takes less time to administer than an IV piggyback (IVPB) medication. The dexamethasone should be administered first.
One of the major functions of the kidneys in maintaining normal fluid balance is:
- A. the manufacture of antidiuretic hormone.
- B. the regulation of calcium and phosphate balance.
- C. the regulation of the pH of the extracellular fluid.
- D. the control of aldosterone levels.
Correct Answer: C
Rationale: Major functions of the kidneys in maintaining normal fluid balance include regulation of extracellular fluid and osmolarity by selective retention and excretion of fluids, regulation of pH of the extracellular fluid by retention of hydrogen ions, and excretion of metabolic wastes and toxic substances. ADH is manufactured by the pituitary, and the parathyroid regulates calcium and phosphate balance.
The 16-year-old is taking acyclovir. Which statement, if made by the adolescent, should indicate to the nurse that the medication is having the desired therapeutic effect?
- A. I am having a regular menstrual cycle now.
- B. That bad odor from my vagina is now gone.
- C. All those sores on my labia are getting better.
- D. I don't have that green vaginal discharge anymore.
Correct Answer: C
Rationale: A: A side effect of acyclovir is a change in the menstrual cycle; however, having a regular menstrual cycle is not the desired therapeutic effect. B: A bad odor from the vagina is a symptom of bacterial vaginosis or trichomoniasis vaginalis, and usually not a symptom of genital herpes simplex. C: Acyclovir (Zovirax), an antiviral medication, is indicated for the treatment of genital herpes simplex virus, shingles, or chicken pox. Labial sores are associated with genital herpes simplex. Improvement of labial sores indicates that acyclovir is having the desired therapeutic effect. D: A green vaginal discharge may be a symptom of Trichomonas, which is treated with metronidazole (Flagyl), an amebicide.