Nokea
The nurse is caring for a client who has dysphagia related to a stroke. The nurse works with the client to explain what food and beverages might minimize aspiration. What is this an example of?
- A. health promotion
- B. secondary prevention
- C. tertiary prevention
- D. primary prevention
Correct Answer: C
Rationale: The goal of tertiary prevention is to improve quality of life while minimizing further injury or symptoms of chronic disease. Primary prevention is used to prevent disease. Secondary prevention focuses on early detection of disease and interventions to prevent worsening of that disease. Health promotion activities are designed to prevent illness and promote wellness.
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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 HCP prescribed a dose of acetaminophen according to weight recommendations for the child weighing 48 lb. The package insert states that the recommended dose is 15 mg per kg. What dose should the nurse administer?
Correct Answer: 327
Rationale: First change 48 lb into kilograms (48 / 2.2 = 21.8 kg). Next determine the dose (21.8 kg x 15 = 327 mg). The child should receive 327 mg of acetaminophen (Tylenol).
The nurse is leading a group session for clients with panic disorder. Which statement made by the client indicates that further teaching is needed?
- A. I need to be able to identify triggers that escalate my anxiety to the point of panic.
- B. Diazepam is the long-term medication of choice because of its nonaddicting quality.
- C. Citalopram has been found to be helpful in the long-term treatment of panic disorder.
- D. I can use guided imagery and meditation to effectively reduce my anxiety symptoms.
Correct Answer: B
Rationale: Buspirone, not diazepam (Valium), is the long-term medication of choice for panic disorder due to its nonaddicting quality.
A nurse teaching a patient with COPD pulmonary exercises should do which of the following?
- A. Teach pursed-lip breathing techniques.
- B. Encourage repetitive heavy lifting exercises that will increase strength.
- C. Limit exercises based on respiratory acidosis.
- D. Take breaks every 10-20 minutes with exercises.
Correct Answer: A
Rationale: Pursed-lip breathing will help decrease the volume of air expelled by increased bronchial airways.
The nurse is developing the plan of care for the 4-year-old client who is taking metronidazole for giardiasis. Which measures should be included in the plan of care? Select all that apply.
- A. Assess cardiac status.
- B. Assess for signs of infection.
- C. Reinforce strict hand washing.
- D. Give metronidazole with food.
- E. Monitor results of stool samples.
Correct Answer: B,C,E
Rationale: A: Metronidazole is not associated with any cardiac changes or adverse events. B: Giardiasis is an infectious diarrheal disease; the plan of care should include assessing for infection. Infection should subside when treated with metronidazole (Flagyl). C: Giardiasis is an infectious diarrheal disease; the plan of care should include reinforcing strict hand washing. D: Metronidazole should be given on an empty stomach. E: Giardiasis is an infectious diarrheal disease; the plan of care should include monitoring the results of stool samples.