Nokea
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.
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The client is admitted to the ED with tachypnea, tachycardia, and hypotension. The client has been taking theophylline for treatment of asthma and erythromycin for an upper respiratory tract infection. Which conclusion and action taken by the nurse is correct?
- A. The client is having an asthma attack; the nurse requests an order for albuterol.
- B. The client is experiencing septicemia; the nurse requests an order for blood cultures.
- C. The client has theophylline toxicity; the nurse requests an order for a serum theophylline level.
- D. The client is allergic to erythromycin; the nurse requests an order for diphenhydramine.
Correct Answer: C
Rationale: A: Symptoms of an asthma attack would include wheezing and other signs of air hunger. B: Additional signs would need to be present to suspect septicemia, such as an elevated temperature and skin flushing. C: Tachypnea, tachycardia, and hypotension are signs of theophylline (Theo-Dur) toxicity. These occur because macrolide antibiotics such as erythromycin inhibit the metabolism of theophylline. Obtaining an order for a theophylline level will expedite the client's treatment. D: Symptoms could suggest an allergic reaction, but epinephrine would be ordered, not diphenhydramine.
A serious complication of a total hip replacement is displacement of the prosthesis. What is the primary sign of displacement?
- A. pain on movement and weight bearing
- B. hemorrhage
- C. affected leg appearing 1-2 inches longer
- D. edema in the area of the incision
Correct Answer: A
Rationale: Pain on movement and weight bearing indicates pressure on the nerves or muscles caused by the dislocation. Other symptoms of dislocation include an inability to bear weight and a shortening of the affected leg. Edema is not a primary sign of displacement.
Methylphenidate hydrochloride is prescribed for the child with ADHD. The nurse should teach the parents to administer the medication in which way?
- A. Whenever the child exhibits inattention behaviors
- B. Whenever the child exhibits hyperactive behaviors
- C. With a snack before bed to calm the child for sleep
- D. During or after meals if the medication decreases appetite
Correct Answer: D
Rationale: A: Methylphenidate is usually given twice daily at or before breakfast and at noon, not whenever inattention behaviors occur. B: Methylphenidate is usually given twice daily at or before breakfast and at noon, not whenever hyperactive behaviors occur. C: The last dose of the medication should be given before 6 p.m. to prevent insomnia. D: A side effect of methylphenidate hydrochloride (Ritalin) is anorexia. It should be given during or immediately after breakfast and lunch to prevent a decreased intake.
In planning care for this client, the nurse should anticipate which of the following side effects to contribute to a sense of altered body image?
- A. cushingoid appearance
- B. alopecia
- C. temporary or permanent sterility
- D. pathologic fractures
Correct Answer: D
Rationale: Pathologic fractures are not common to the disease process. Its treatment through osteoporosis is a potential complication of steroid use. Hodgkin's disease most commonly affects young adults (males), is spread through lymphatic channels to contiguous nodes, and also might spread via the hematogenous route to extradal sites (GI, bone marrow, skin, and other organs). A working staging classification is performed for clinical use and care.
The client being treated for opiate dependence is receiving a buprenorphine/naloxone combination. The nurse understands that the reason for adding naloxone to the treatment with buprenorphine is for what effect?
- A. Prevent opiate intoxication should the client abuse an opiate.
- B. Replace essential nutrients due to malnutrition from drug abuse.
- C. Reduce the incidence of adverse reactions of the buprenorphine.
- D. Induce an adverse reaction if the client uses an opiate while on buprenorphine.
Correct Answer: A
Rationale: Naloxone in buprenorphine/naloxone (Suboxone) blocks opiate receptors, preventing intoxication if opiates are abused.