Nokea
The nurse is caring for a client with an acute exacerbation of Bell's palsy. The nurse anticipates that the physician will prescribe which medications? Select all that apply.
- A. Prednisone
- B. Donepezil
- C. Pyridostigmine
- D. Valacyclovir
- E. Topiramate
Correct Answer: A,D
Rationale: Prednisone (a corticosteroid) reduces inflammation, and valacyclovir (an antiviral) addresses possible viral causes in Bell's palsy. Donepezil, pyridostigmine, and topiramate are not indicated.
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The nurse is caring for an elderly home health client experiencing a sudden onset of delirium. Which of the following should the home health nurse assess first?
- A. Drug intoxication
- B. Increased hearing loss
- C. Cancer metastases
- D. Congestive heart failure
Correct Answer: A
Rationale: Drug intoxication is a common and reversible cause of delirium in the elderly.
The nurse is preparing to teach a client who was recently diagnosed with Meniere's disease. To help the client reduce the incidence of attacks, the nurse should recommend that the client do which of the following?
- A. Irrigate their ears with sterile water.
- B. Reduce dietary sodium intake.
- C. Do not use earbuds or headphones.
- D. Speak with limited inflections.
Correct Answer: B
Rationale: Reducing sodium intake helps manage fluid balance in Meniere's disease, reducing attack frequency.
The nurse has received a prescription for midazolam. Which of the following client findings requires follow-up with the physician prior to administering this medication?
- A. Cocaine intoxication
- B. Respiratory acidosis
- C. Tonic-clonic seizures
- D. Aggression
Correct Answer: B
Rationale: Midazolam, a benzodiazepine, can cause respiratory depression, which is dangerous in clients with respiratory acidosis. Tonic-clonic seizures are an indication for midazolam, while cocaine intoxication and aggression are less directly contraindicated.
The nurse is caring for a client prescribed tizanidine. The nurse understands that this medication has had a therapeutic effect when the client reports
- A. Increased ability to focus
- B. Decreased muscle spasms
- C. Improved short-term memory
- D. Sleeping without awakening at night
Correct Answer: B
Rationale: Tizanidine is a muscle relaxant used to treat spasticity. A therapeutic effect is indicated by decreased muscle spasms. Increased focus, improved memory, and better sleep are not primary effects of tizanidine.
The nurse is reviewing laboratory data for a client with epilepsy taking prescribed valproic acid (VPA). The client's VPA level is 40 mcg/mL (50-125 mcg/mL). Based on the laboratory data, the nurse should
- A. Evaluate the client for non-adherence
- B. Instruct the client to skip the next scheduled dose
- C. Assess the client for VPA toxicity
- D. Document the result as within normal limits
Correct Answer: A
Rationale: A VPA level of 40 mcg/mL is below the therapeutic range (50-125 mcg/mL), suggesting possible non-adherence to the prescribed regimen. Skipping a dose is inappropriate, toxicity is unlikely with a low level, and the result is not within normal limits.