Nokea
The nurse is caring for a client newly prescribed ropinirole. The nurse understands that this medication is prescribed to treat which condition?
- A. Multiple Sclerosis
- B. Parkinson disease
- C. Schizophrenia
- D. Guillain-Barré syndrome
Correct Answer: B
Rationale: Ropinirole is a dopamine agonist used to treat Parkinson's disease by improving motor symptoms. It is not indicated for Multiple Sclerosis, Schizophrenia, or Guillain-Barré syndrome, which involve different pathophysiology and treatments.
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The nurse is performing a medication reconciliation for a client taking prescribed phenytoin. Which medication should the nurse question with the physician while the client is taking phenytoin?
- A. Thiamine
- B. Prazosin
- C. Warfarin
- D. Acyclovir
Correct Answer: C
Rationale: Phenytoin induces liver enzymes, which can decrease warfarin's effectiveness, increasing the risk of clotting. Thiamine, prazosin, and acyclovir have no significant interactions with phenytoin.
The nurse is caring for an older adult with advanced dementia. The client asks about her deceased sister, 'When will my sister come to visit me this afternoon?' Which is the best response from the nurse?
- A. This is so sad. I'm sorry to tell you but your sister died last year.'
- B. She won't be coming to visit today.'
- C. I understand you want her to visit you. Where did you and your sister grow up?'
- D. Wait and see if she comes to visit today.'
Correct Answer: C
Rationale: Redirecting the conversation compassionately avoids distress and engages the client with dementia.
The nurse has received a prescription for a mannitol infusion. Which type of intravenous tubing should be used to administer mannitol?
- A. Microdrip
- B. Filtered
- C. Vented
- D. Non-vented
Correct Answer: B
Rationale: Mannitol is a hyperosmolar diuretic that can crystallize in IV tubing, potentially causing blockages. Filtered tubing is required to prevent crystals from entering the bloodstream, ensuring safe administration. Microdrip, vented, and non-vented tubing do not address this risk.
The following scenario applies to the next 6 items
The nurse in the emergency department (ED) is caring for a 20-year-old female client
Item 2 of 6
ED Triage Note
History And Physical
0912: Client was brought to the ED by her two college roommates 'because she was not acting right.' The roommate reports that she went to bed the night before reporting stiffness in her neck and a headache. She attributed it to being under pressure with final exams and having poor sleep the previous several days. The client apparently took non-prescribed lorazepam from another roommate to assist her with sleep. The roommate reported recently having influenza and is unsure if she became infected. It is reported that she declined the influenza vaccination when it was offered on campus. The roommate reports waking her with physical stimuli and found her diaphoretic, hot to touch, and mumbling, saying she did not feel well.
Vital signs: T 103.4° F (39.7° C), P 112, RR 12, BP 116/86, pulse oximetry 95% on room air.
For each client finding below, click to specify if the finding is consistent with the disease process of benzodiazepine toxicity, bacterial meningitis, or influenza:
- A. Altered mental status
- B. Fever
- C. Petechial rash
- D. Altered speech pattern
- E. Neck stiffness
Correct Answer: A,B,C,B,A,B
Rationale: Altered mental status is common in benzodiazepine toxicity (sedation) and bacterial meningitis (infection-related). Fever is typical in bacterial meningitis and influenza. Petechial rash is a hallmark of bacterial meningitis, especially meningococcal. Altered speech can occur in benzodiazepine toxicity (slurred speech) and meningitis (neurological impairment). Neck stiffness is a classic sign of bacterial meningitis.
The nurse is caring for a client following a stroke. The client can understand instructions but is unable to express himself verbally. The nurse anticipates that this stroke has impacted which lobe of the client's brain?
- A. Frontal lobe
- B. Parietal lobe
- C. Temporal lobe
- D. Occipital lobe
Correct Answer: A
Rationale: Expressive aphasia is associated with frontal lobe stroke, particularly Broca's area.