Nokea
The nurse evaluates a client's knowledge as deficient when the client makes which of the following statements about the drug dexamethasone (Decadron)?
- A. I cannot stop the Decadron all at one time.'
- B. If I forget a dose, it's no big deal; I'll just take it when I remember it.'
- C. When I get a cold, I need to let my doctor know.'
- D. I need to watch for an allergic reaction when I first start taking Decadron.'
Correct Answer: B
Rationale: Dexamethasone requires consistent dosing, and missing a dose can have significant effects, indicating a need for further instruction.
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The doctor orders a midstream urine specimen for your client who is an alert, oriented and ambulatory female client. What element should you include in your instructions to this client on the proper manner to collect this specimen?
- A. The need to cleanse the perineal area with circular wipes.
- B. The need to cleanse the perineal area from the 'dirtiest' to the 'cleanest'.
- C. The need to use a new antiseptic wipe for each wipe from the inner to the outer labia.
- D. The need to use a new antiseptic wipe for each wipe from the outer to the inner labia.
Correct Answer: C
Rationale: For a midstream urine specimen, the perineal area should be cleansed from front to back (inner to outer labia) using a new antiseptic wipe for each stroke to prevent contamination.
You are working as a wound care nurse. You measure the size of a client's wound and it is 3 cm deep, 2 cm long and 4 cm wide. You would document the dimension of this wound as:
- A. 6 cm
- B. 12 cm
- C. 20 cm
- D. 24 cm
Correct Answer: B
Rationale: Wound dimensions are typically documented as length x width x depth (2 cm x 4 cm x 3 cm), but based on options, 12 cm may reflect a calculation error; correct documentation is individual measurements.
A 20-year-old single parent brings her 3-year-old son into the emergency department because he 'fell.' The child has bruises on his face, arms, and legs; his mother says that she did not witness the fall. The nurse suspects child abuse. While examining the child, the mother says, 'Sometimes I guess I'm pretty rough with him. I'm alone, and I just don't know how to manage him.' The nurse should ask the mother if she would find it helpful to have a referral to:
- A. A program for single parents.
- B. A parenting education program.
- C. A women's support group.
- D. A support group for abusive parents.
Correct Answer: B
Rationale: A parenting education program would provide the mother with skills to manage her child's behavior appropriately, addressing potential abuse triggers and improving parenting techniques.
A client with a diagnosis of systemic lupus erythematosus (SLE) is prescribed hydroxychloroquine (Plaquenil). The nurse should monitor the client for which of the following side effects?
- A. Weight gain.
- B. Retinal toxicity.
- C. Hypoglycemia.
- D. Hair loss.
Correct Answer: B
Rationale: Hydroxychloroquine can cause retinal toxicity, requiring regular eye exams to monitor for vision changes.
A child has been prescribed diphenhydramine hydrochloride (Benadryl) to help control the itching from atopic dermatitis. The nurse should instruct the parents to report: Select all that apply.
- A. Weight loss.
- B. Drowsiness.
- C. Thickened bronchial secretions.
- D. Upset stomach.
- E. Bradycardia.
Correct Answer: B, C, D
Rationale: Diphenhydramine can cause drowsiness, thickened bronchial secretions, and upset stomach as side effects, which should be reported.