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The nurse is caring for a client with angle-closure glaucoma. Which prescription should the nurse anticipate from the primary healthcare provider (PHCP)?
- A. timolol
- B. hydroxyzine
- C. phenylephrine
- D. imipramine
Correct Answer: A
Rationale: Timolol, a beta-blocker, reduces intraocular pressure in angle-closure glaucoma by decreasing aqueous humor production. Hydroxyzine, phenylephrine, and imipramine are not used for this condition.
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A 20-year-old who hit his head while playing football has a tonic-clonic seizure. Upon awakening from the seizure, the client asks the nurse, "What caused me to have a seizure? I've never had one before." Which cause should the nurse include in the response as a primary cause of tonic-clonic seizures in adults older than age 20?
- A. Head trauma.
- B. Electrolyte imbalance.
- C. Congenital defect.
- D. Epilepsy.
Correct Answer: A
Rationale: Head trauma is a primary cause of seizures in adults over 20, especially in the context of a recent injury. Electrolyte imbalances, congenital defects, or epilepsy are less likely without additional history.
A health care provider orders 0.5 mg of protamine sulfate for a client who is showing signs of bleeding after receiving a 100-unit dose of heparin. The nurse should expect the effects of the protamine sulfate to be noted in which of the following time frames?
- A. 5 minutes.
- B. 10 minutes.
- C. 20 minutes.
- D. 30 minutes.
Correct Answer: C
Rationale: Protamine sulfate neutralizes heparin rapidly, with effects typically seen within 20 minutes of administration. This allows for quick reversal of heparin's anticoagulant effects in cases of bleeding. The other time frames are either too short or too long.
Which of the following statements would provide the best guide for activity during the rehabilitation period for a client who has been treated for retinal detachment?
- A. Activity is resumed gradually, and the client can resume her usual activities in 5 to 6 weeks.
- B. Activity level is determined by the client's tolerance; she can be as active as she wishes.
- C. Activity level will be restricted for several months, so she should plan on being sedentary.
- D. Activity level can return to normal and may include regular aerobic exercises.
Correct Answer: A
Rationale: Gradual resumption of activity over 5 to 6 weeks allows the retina to heal properly while minimizing the risk of re-detachment or complications.
A nurse is teaching a client about taking antihistamines. Which of the following instructions should the nurse include in the teaching plan? Select all that apply.
- A. Operating machinery and driving may be dangerous while taking antihistamines.
- B. Committaking antihistamines even if nasal infection develops.
- C. The effect of antihistamines is not felt until a day later.
- D. Do not use alcohol with antihistamines.
- E. Increase fluid intake to 2,000 mL/day.
Correct Answer: A,D,E
Rationale: Antihistamines have an anticholinergic action and a drying effect and reduce nasal, salivary, and lacrimal gland hypersecretion (runny nose, tearing, and itching eyes). An adverse effect is drowsiness, so operating machinery and driving are not recommended. There is also an additive depressant effect when alcohol is combined with antihistamines, so alcohol should be avoided during antihistamine use. The client should ensure adequate fluid intake of at least 8 glasses per day due to the drying effect of the drug.
The nurse is planning a home visit for a client with hepatitis. In order to prevent transmission the nurse should focus teaching on:
- A. Proper food handling.
- B. Insulin syringe disposal.
- C. Alpha-interferon.
- D. Use of condoms.
Correct Answer: D
Rationale: Hepatitis B and C are transmitted via body fluids, so condom use (D) prevents sexual transmission. Food handling (A) is key for hepatitis A, syringe disposal (B) applies to needle-sharing, and alpha-interferon (C) is a treatment, not a preventive measure.