Nokea
The LPN receives a call from a mother caring for her eight-month-old infant. The mother describes that the child has a low-grade fever and has teeth breaking through the gums. Which of the following measures would be inappropriate to recommend to the mother?
- A. Allow the child to chew on a cooled teething ring.
- B. Massage the child's gums gently.
- C. Administer acetaminophen.
- D. Administer aspirin.
Correct Answer: D
Rationale: Aspirin should not be recommended as a pain medication for children due to the increased risk of Reye's syndrome.
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The client with Addison's disease is taking fludrocortisone 100 mcg orally once daily. Which statement made by the client regarding the fludrocortisone therapy requires further teaching by the nurse?
- A. I should talk to my health care provider about getting a flu shot this year.
- B. I should stop taking fludrocortisone if my blood sugar levels are too high.
- C. I should check my weight, blood pressure, and pulse once every morning.
- D. I should eat foods higher in potassium like bananas, melons, and pears.
Correct Answer: B
Rationale: A: The client should check with the HCP about getting vaccinations such as influenza; a chronic condition increases the client's risk for other illnesses and complications. B: The client needs further teaching if stating that he or she will stop taking fludrocortisone (Florinef) if his or her blood sugar levels are too high; stopping mineralocorticoid replacement therapy abruptly may lead to addisonian crisis. C: Common adverse effects of fludrocortisone include edema, arrhythmias, and hypertension; stating that he or she should monitor weight, BP, and pulse daily is appropriate. D: Common adverse effects of fludrocortisone include hypokalemia; stating that he or she should consume potassium-rich foods is appropriate.
The client taking lithium for bipolar disorder participated in a recreational game of basketball in the mental health unit gym. The client is now feeling nauseated and shaky, has blurred vision, and is finding it hard to stand. Considering this information, which action should be taken by the nurse?
- A. Instruct the client to sit and rest for a while in a cool place.
- B. Call the HCP to request an order for a STAT serum lithium level.
- C. Give the prn prescribed antiemetic with a large glass of cold water.
- D. Alert the emergency team for the client's impending cardiac arrest.
Correct Answer: B
Rationale: The client is showing signs of lithium (Lithane) toxicity, especially apparent after high levels of physical activity. The HCP should be notified for a STAT lithium level and corrective action.
The nurse is caring for a female client who has recently been diagnosed with cancer and will soon begin chemotherapy. Which of these statements would require additional follow-up and education?
- A. I will be most susceptible to an infection between 7 and 12 days after chemotherapy.
- B. I should try to get my annual teeth cleaning in before beginning chemotherapy.
- C. I should wait until all my hair falls out to purchase a wig.
- D. I should try to drink 8-10 glasses of water a day.
Correct Answer: C
Rationale: This client is at risk for altered body image secondary to the hair loss from chemotherapy. A wig can be helpful in coping with this, and the client should shop for a wig before his or her hair falls out so that he or she can better match his or her color and style. The remaining statements are accurate.
New medications are prescribed for the client taking lithium. Which medication, if prescribed, should the nurse question with the HCP?
- A. Isosorbide dinitrate by mouth tid
- B. Prednisone 20 mg by mouth daily
- C. Furosemide 80 mg by mouth daily
- D. Insulin aspart 2 units subcut with meals
Correct Answer: C
Rationale: Furosemide (Lasix) is a loop diuretic that promotes sodium loss and lithium retention, increasing serum lithium levels and risk of toxicity.
Which of these medications has the least risk of causing tinnitus?
- A. Aspirin
- B. Lasix
- C. Gentamicin
- D. Fluoxetine
Correct Answer: D
Rationale: Gentamicin, Lasix, and Aspirin are all ototoxic drugs that have a potential side effect of causing tinnitus, a ringing in the ear. Fluoxetine, an SSRI, is not typically associated with tinnitus.