Nokea
The nurse is caring for a female client who has recently been diagnosed with cancer and will soon begin chemotherapy. Which of these statements would require additional follow-up and education?
- A. I will be most susceptible to an infection between 7 and 12 days after chemotherapy.
- B. I should try to get my annual teeth cleaning in before beginning chemotherapy.
- C. I should wait until all my hair falls out to purchase a wig.
- D. I should try to drink 8-10 glasses of water a day.
Correct Answer: C
Rationale: This client is at risk for altered body image secondary to the hair loss from chemotherapy. A wig can be helpful in coping with this, and the client should shop for a wig before his or her hair falls out so that he or she can better match his or her color and style. The remaining statements are accurate.
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The nurse evaluates that pancrelipase is having the optimal intended benefit for the client with CF. Which assessment finding prompted the nurse's conclusion?
- A. The client lost 4 pounds in 1 month.
- B. The client no longer has heartburn.
- C. The client has increased steatorrhea.
- D. The client has improved nutritional status.
Correct Answer: D
Rationale: A: Weight gain, not weight loss, is an intended effect. B: Pancrelipase is not used to treat abdominal heartburn. C: Pancrelipase reduces the amount of fatty stools (steatorrhea). D: Pancrelipase (Pancreaze) is a pancreatic enzyme used in clients with deficient exocrine pancreatic secretions, CF, chronic pancreatitis, or steatorrhea from malabsorption syndrome. Because it aids digestion, the nutritional status should be improved.
The LPN is performing an assessment on a 4-day-old 8-pound, 6-ounce newborn with a head circumference of 33 cm. Given this information, what would the nurse expect the child's chest circumference to be?
- A. about 31 cm
- B. about 36 cm
- C. about 29 cm
- D. about 33 cm
Correct Answer: A
Rationale: In newborns, the head circumference should be 2 cm to 3 cm larger than the chest circumference. Note: Due to molding that occurs during the birth process, the head and chest measurement may be nearly equal during the first 48 hours after birth.
The 8-year-old child with gastroenteritis is prescribed to receive 500 mL of lactated Ringer's (LR) solution over the next 10 hours. How many milliliters per hour should the nurse administer?
Correct Answer: 50
Rationale: 500 mL / 10 hr = 50 mL/hr
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.
The parent of the 2-year-old with asthma has been given instructions about asthma control and Step Therapy. Which statement, if made by the parent, should indicate to the nurse that the parent has an adequate understanding of the instructions?
- A. If my child has wheezing twice a week or less, I should add the nebulized corticosteroid and make an appointment.
- B. If my child has a respiratory tract infection I should add the nebulized corticosteroid and make an appointment.
- C. If my child has to use the nebulizer less than twice a week, I should add the nebulized corticosteroid and make an appointment.
- D. If my child has nighttime awakenings with wheezing twice a month or more, I should add the nebulized corticosteroid and make an appointment.
Correct Answer: D
Rationale: A: Asthma symptoms (wheezing) occurring 2 or fewer days per week should be treated at Step 1. B: A respiratory tract infection may require the increased use of short-acting beta agonists, but an inhaled corticosteroid should not be added until the child is evaluated by the HCP. C: The use of the nebulizer twice a week or less should be treated at Step 1. D: Nighttime waking with asthma symptoms 1 to 2 times per month indicates the need to proceed to Step 2 therapy, which includes the use of an inhaled corticosteroid.