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The nurse is concerned that the adolescent may be developing a side effect of methotrexate. Which test or exam results should the nurse review prior to administration?
- A. Folic acid level
- B. Serum electrolytes
- C. Complete blood count
- D. Activated partial prothrombin time
Correct Answer: C
Rationale: A: Although methotrexate is a folic acid antagonist, it does not alter serum levels. B: Methotrexate has no effect on electrolytes. C: An adverse effect of methotrexate (Trexall) is aplastic anemia; thus, the nurse should review the CBC results before administration. D: Methotrexate has no effect on coagulation.
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The nurse is discussing the prescribed atypical antipsychotic medication therapy with the client with schizophrenia. What information should the nurse include in this discussion? Select all that apply.
- A. Atypical antipsychotic medications will affect the client's hallucinations and inappropriate emotional responses.
- B. Atypical antipsychotic medications are prescribed after other medications have proven ineffective in treating symptoms.
- C. The greatest concern with taking atypical antipsychotic medications is that they produce extrapyramidal side effects.
- D. Regular laboratory appointments will need to be scheduled to monitor the client's blood glucose levels.
- E. The client may experience an increase in appetite and weight gain when taking an atypical antipsychotic medication.
Correct Answer: A,D,E
Rationale: Atypical antipsychotics target hallucinations and emotional responses, require blood glucose monitoring, and may cause increased appetite and weight gain.
Which of the following is least appropriate when caring for a stable postpartum client?
- A. Assess the location and height of the fundus.
- B. Conduct a family assessment, including the mother's future plans for going back to work, if applicable.
- C. Monitor the client for bleeding.
- D. Provide perineal care.
Correct Answer: B
Rationale: A family assessment is more appropriate after the client(s) have been discharged from the hospital. In the immediate postpartum stage, the nurse should provide perineal care, monitor for bleeding, and assess the location and height of the fundus.
The nurse is caring for a 4-year-old client. What is the most appropriate pain scale for the nurse to use during the assessment?
- A. McGill Pain Scale
- B. FLACC Pain Scale
- C. CRIES Pain Scale
- D. Wong-Baker Pain Scale
Correct Answer: D
Rationale: The Wong-Baker Pain Scale uses faces to identify the level of pain. Children over the age of 3 should use this scale to articulate their subjective feeling of pain as opposed to objective measures using the CRIES or FLACC Pain Scales. The McGill Pain Scale uses many words to characterize pain and is more appropriate for adult clients.
The nurse completes teaching with the client who will be taking daily doses of disulfiram following treatment for alcoholism. Which client statement indicates correct understanding of the safe use of disulfiram?
- A. If I take disulfiram and then drink alcohol, I will become intoxicated much more quickly.
- B. I should take disulfiram in the morning so that I will be more alert throughout the day.
- C. If I do drink any alcohol, I should skip the daily dose of disulfiram to avoid becoming ill.
- D. I should avoid extracts and cough preparations containing alcohol while taking disulfiram.
Correct Answer: D
Rationale: The client should avoid alcohol-containing substances (e.g., cough preparations, extracts) to prevent severe adverse reactions with disulfiram (Antabuse).
The LPN is caring for a 9 month-old infant. Which of these behaviors exhibited by the child warrants further investigation?
- A. She prefers crawling and is making no attempt to walk.
- B. She seems distressed with new adults.
- C. She does not respond to her own name.
- D. She only babbles "mama" and "dada."
Correct Answer: C
Rationale: By 9 months, children should be babbling simple words and crawling, and they should recognize and respond to their own name. They may begin attempting to walk or may just be starting to attempt to pull themselves up to stand. Strangers often produce fear or anxiety in infants this age.