Nokea
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.
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The client has a new prescription for metoclopramide. The nurse notifies the HCP because the client has a contraindication for metoclopramide use. Which information in the client's medical record most likely prompted the nurse's notification of the HCP?
- A. Use of nasogastric suctioning
- B. History of diabetes mellitus
- C. History of seizure disorders
- D. Chemotherapy treatment for cancer
Correct Answer: C
Rationale: A: The use of NG suctioning alone would not prevent metoclopramide use. Metoclopramide can be administered through the NG tube; the tube is then clamped for an hour after administration until absorption occurs. B: Metoclopramide should be used with caution with DM, but it is not contraindicated. C: The client's history of a seizure disorder would contraindicate the use of metoclopramide. Because metoclopramide (Reglan) blocks dopamine receptors in the chemoreceptor trigger zone of the CNS, it is contraindicated in seizure disorders. D: Metoclopramide is used in the treatment of nausea and vomiting for clients receiving chemotherapy.
The nurse working on the pediatric unit has scheduled medications to administer at this time. Which assessments should prompt the nurse to conclude that the prescribed medication should be withheld and the HCP immediately notified?
- A. Oral hydrocodone with acetaminophen to the 10-year-old with burn injuries who is feeling dizzy and light-headed
- B. Oral acetaminophen to the 6-month-old with a fever of 102°F (38.9°C) from an infection who has developed a rash
- C. Clindamycin IV to the 16-year-old male with aspiration pneumonia from near-drowning who has a BP of 92/56 mm Hg
- D. Phenobarbital IV to the 5-year-old with intermittent seizures who states feeling tired and appears to be drowsy
Correct Answer: C
Rationale: A: Dizziness and light-headedness are side effects of hydrocodone with acetaminophen (Vicodin), and the nurse may choose to withhold a scheduled dose. These are not potentially life-threatening or warranting an immediate call to the HCP. B: A rash is a side effect of acetaminophen (Tylenol). However, the rash is not potentially life-threatening or warranting an immediate call to the HCP. C: An adverse effect of clindamycin (Cleocin) is hypotension. A BP of 92/56 mm Hg is low for a 16-year-old. Normal BP for a 16-year-old male is 111/63 mm Hg to 136/90 mm Hg, depending on height percentile. The nurse should compare the previous BP readings with the current one to determine the degree of BP variation and then immediately notify the HCP because the BP can decrease further. D: Tiredness and drowsiness are side effects of phenobarbital (Luminal). However, these are expected. The nurse would not withhold phenobarbital unless there were additional neurological alterations that would warrant contacting the HCP.
The HCP's progress notes state a plan to initiate an oral NSAID for the child's pain. Based on this information, the nurse should consult with the HCP when noting that which medication was the only analgesic prescribed?
- A. Naproxen
- B. Tolmetin
- C. Ibuprofen
- D. Hydromorphone
Correct Answer: D
Rationale: A: Naproxen (Aleve) is an NSAID. B: Tolmetin (Tolectin) is an NSAID. C: Ibuprofen (Advil, Motrin) is an NSAID. D: Hydromorphone (Dilaudid) is an opioid analgesic, not an NSAID.
The nurse evaluates that pancrelipase is having the optimal intended benefit for the client with CF. Which assessment finding prompted the nurse's conclusion?
- A. The client lost 4 pounds in 1 month.
- B. The client no longer has heartburn.
- C. The client has increased steatorrhea.
- D. The client has improved nutritional status.
Correct Answer: D
Rationale: A: Weight gain, not weight loss, is an intended effect. B: Pancrelipase is not used to treat abdominal heartburn. C: Pancrelipase reduces the amount of fatty stools (steatorrhea). D: Pancrelipase (Pancreaze) is a pancreatic enzyme used in clients with deficient exocrine pancreatic secretions, CF, chronic pancreatitis, or steatorrhea from malabsorption syndrome. Because it aids digestion, the nutritional status should be improved.
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.