Nokea
The nurse is caring for a client interested in pre-exposure prophylaxis for human immunodeficiency virus (HIV). Which prescription would the nurse anticipate?
- A. Voriconazole
- B. Tenofovir-emtricitabine
- C. Raloxifene
- D. Lurasidone
Correct Answer: B
Rationale: Tenofovir-emtricitabine (Truvada) is approved for pre-exposure prophylaxis (PrEP) to prevent HIV infection in high-risk individuals. Choice A (voriconazole) is an antifungal, Choice C (raloxifene) is for osteoporosis, and Choice D (lurasidone) is an antipsychotic.
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College freshman are participating in a study abroad program. When teaching them about hepatitis B, the nurse should instruct the students on:
- A. Water sanitation.
- B. Single dormitory rooms.
- C. Vaccine for hepatitis B.
- D. Safe sexual practices.
Correct Answer: D
Rationale: Hepatitis B is transmitted through blood and body fluids, so safe sexual practices (D) are critical for prevention. Water sanitation (A) is relevant for hepatitis A, single rooms (B) are unnecessary, and while vaccination (C) is important, the question focuses on behavioral instruction.
A 62-year-old male with a history of chronic obstructive pulmonary disease (COPD) and metastatic carcinoma of the lung has not responded to radiation therapy and is being admitted to the hospice program. The nurse should conduct a focused client assessment for:
- A. Ascites.
- B. Pleural friction rub.
- C. Dyspnea.
- D. Peripheral edema.
Correct Answer: C
Rationale: Dyspnea is a priority assessment for a client with COPD and metastatic lung cancer, as it is a common and distressing symptom requiring palliation in hospice care.
The nurse is preparing a client for a total hip replacement. Which preoperative teaching should be included to prevent postoperative complications?
- A. Avoid crossing legs after surgery.
- B. Practice using a walker before surgery.
- C. Limit fluid intake the day before surgery.
- D. Perform arm exercises to strengthen muscles.
Correct Answer: A
Rationale: Avoiding leg crossing prevents hip dislocation, a common complication after total hip replacement. This teaching is critical for postoperative safety and recovery.
A 10-year-old client is diagnosed with infectious mononucleosis. Her white blood cell (WBC) count is 19,000/µL. She has a streptococcal throat infection and her spleen is enlarged. She has aching muscles. Which of the following instructions should the nurse include in discharge planning with the client and the essential caregiver? Select all that apply.
- A. Stay on bed rest until the temperature is normal.
- B. Gargle with warm saline while the throat is irritated.
- C. Increase intake of fluids until the infection subsides.
- D. Take aspirin as long as the fever and myalgia persist.
- E. Avoid contact sports while the spleen is enlarged.
Correct Answer: B,C,E
Rationale: Infectious mononucleosis with an enlarged spleen requires avoiding contact sports to prevent splenic rupture, a serious complication. Gargling with warm saline soothes the throat, and increased fluids support recovery and prevent dehydration. Bed rest is not strictly necessary unless fever persists, and aspirin should be avoided in children due to the risk of Reye's syndrome.
A hospice client's family asks how they will know when death is imminent. The nurse should explain that signs include:
- A. Increased energy and mobility.
- B. Cheyne-Stokes respirations.
- C. Improved blood pressure.
- D. Clear lung sounds.
Correct Answer: B
Rationale: Cheyne-Stokes respirations, characterized by alternating periods of apnea and deep breathing, are a common sign of imminent death.