Nokea
The nurse is caring for a client with Bell's palsy. Which of the following prescriptions should the nurse anticipate administering to the client?
- A. Modafinil
- B. Prednisone
- C. Doxycycline
- D. Acyclovir
- E. Sumatriptan
Correct Answer: B,D
Rationale: Prednisone reduces inflammation, and acyclovir treats potential viral causes in Bell's palsy.
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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.
The nurse is preparing a staff in-service regarding sensorineural hearing loss. It would be appropriate for the nurse to identify which factors cause this type of hearing loss?
- A. Presbycusis
- B. Ototoxic substance
- C. Foreign body
- D. Exposure to loud noise
- E. Edema
Correct Answer: A,B,D
Rationale: Presbycusis, ototoxic substances, and loud noise exposure cause sensorineural hearing loss by damaging the inner ear or auditory nerve.
The nurse is assessing a client who is suspected of having myasthenia gravis. Which of the following would be an expected finding?
- A. Diplopia
- B. Butterfly rash
- C. Facial muscle weakness
- D. Shuffling gait
- E. Ptosis
Correct Answer: A,C,E
Rationale: Diplopia, facial muscle weakness, and ptosis are common in myasthenia gravis due to neuromuscular junction dysfunction.
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 gives discharge instructions to a client who sustained a brain injury from a motor vehicle accident. His wife is concerned regarding her husband having seizures at home. Which statement from the wife indicates that she understood the nurse's teaching?
- A. I will make sure that my husband does not wet himself.'
- B. I will clear all furniture that might injure him when he has a seizure.'
- C. I will call 911 once he has a seizure lasting about 3 minutes.'
- D. I will ensure he sleeps well after a seizure.'
Correct Answer: B
Rationale: Clearing furniture prevents injury during seizures, indicating understanding of safety measures.