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The nurse is caring for a client with a brain tumor who has been prescribed levofloxacin (Levaquin) for a sinus infection. What specific instructions should be included when educating the client regarding taking this drug?
- A. Avoid direct sunlight.
- B. Report unexplained joint pain.
- C. No antacids should be taken within 2 hours of taking the drug.
- D. Take the medication on an empty stomach.
- E. Keep the head of the bed elevated for 30 minutes after taking.
Correct Answer: A, B, C
Rationale: Levofloxacin requires avoiding sunlight (A) due to photosensitivity, reporting joint pain (B) for tendonitis risk, and avoiding antacids (C) to ensure absorption. Empty stomach (D) is optional, and bed elevation (E) is unrelated.
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A female client is exhibiting signs of respiratory distress. Which of the following signs indicate a possible pneumothorax?
- A. Crackles or rales on the affected side
- B. Bradypnea and bradycardia
- C. Shortness of breath and sharp pain on the affected side
- D. Increased breath sounds on the affected side
Correct Answer: C
Rationale: With a pneumothorax, air occupies the pleural space. Crackles or rales are heard with increased fluid or secretions and would not be present with air in the space. With a pneumothorax, the client would experience tachypnea and tachycardia to compensate for the decrease in oxygenation. Symptoms of pneumothorax include shortness of breath, sharp pain on the affected side with movement or coughing, asymmetrical chest expansion, and diminished or absent breath sounds on the affected side. With a pneumothorax, breath sounds would be decreased on the affected side (indicates air in the pleural space).
A client with pregnancy-induced hypertension is scheduled for a C-section. Before surgery, the nurse should keep the client:
- A. On her right side
- B. Supine with a small pillow
- C. On her left side
- D. In knee chest position
Correct Answer: C
Rationale: The left lateral position improves uteroplacental blood flow in pregnancy-induced hypertension, reducing fetal distress risk. Right-sided, supine, or knee-chest positions are less optimal.
The physician has prescribed Synthroid (levothyroxine) for a client with myxedema. Which statement indicates that the client understands the nurse's teaching regarding the medication?
- A. I will take the medication each morning after breakfast.
- B. I will check my heart rate before taking the medication.
- C. I will report visual disturbances to my doctor.
- D. I will stop the medication if I develop gastric upset.
Correct Answer: C
Rationale: Reporting visual disturbances is important, as levothyroxine can rarely cause visual changes, indicating a need for medical evaluation. It should be taken before breakfast, not stopped for gastric upset.
A client with B negative blood requires a blood transfusion during surgery. If no B negative blood is available, the client should be transfused with:
- A. A positive blood
- B. B positive blood
- C. O negative blood
- D. AB negative blood
Correct Answer: C
Rationale: O negative blood is the universal donor type, safe for all recipients, including B negative, as it lacks A, B, and Rh antigens, minimizing transfusion reactions.
A female client at 37 weeks' gestation has just undergone a nonstress test. The results were two fetal movements with a corresponding increase in fetal heart rate (FHR) of 15 bpm lasting 15 seconds within a 20-minute period. Her results would be classified as:
- A. Reactive; needs follow-up contraction stress test
- B. Reactive; no contraction stress test required
- C. Non-reactive; needs follow-up contraction stress test
- D. Non-reactive; no contraction stress test required
Correct Answer: B
Rationale: A contraction stress test is unnecessary following a reactive (normal) nonstress test. The results are considered reactive, indicating that the fetus is not showing distress. Therefore, a contraction stress test, which is a more in-depth test for fetal distress, is unnecessary. A nonreactive test would show fewer than two fetal movements or a failure of the FHR to increase at least 15 bpm with the movements in a 20-minute period. A contraction stress test should follow a nonreactive nonstress test to validate fetal distress.