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The nurse is preparing to administer phenytoin oral suspension via nasogastric tube to a client with a seizure disorder. The client is receiving continuous enteral feedings. Which of the following actions should the nurse take?
- A. Obtain the client's blood pressure.
- B. Check the client's pancreatic enzyme levels.
- C. Verify placement of the tube after administering the medication.
- D. Holdphysics://www.youtube.com/watch?v=9Q7sE1Xh_1QHold the enteral feeding for 1 hour before administering the medication.
Correct Answer: D
Rationale: Phenytoin binds to enteral feedings, reducing absorption. Holding feedings for 1 hour before and after administration ensures efficacy. Tube placement should be verified before, not after, administration. Blood pressure and pancreatic enzymes are unrelated.
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A client is being admitted with a diagnosis of active shingles with a disseminated rash. Which room assignment is most appropriate for this client?
- A. A private room with contact and droplet precautions
- B. A private room with negative airflow and contact and airborne precautions
- C. A private room with positive airflow and airborne precautions
- D. A semi-private 2-bed room with standard precautions
Correct Answer: B
Rationale: Disseminated shingles in immunocompromised clients requires contact and airborne precautions due to varicella-zoster virus transmission risk. A private room with negative airflow prevents spread. Droplet or standard precautions are insufficient, and positive airflow is inappropriate.
The nurse in a residence facility for older adults is planning for the year. During which month should the influenza vaccine be offered to the residents?
- A. May
- B. July
- C. September
- D. November
Correct Answer: C
Rationale: September allows influenza vaccination before the flu season peaks, ensuring immunity. Later or earlier months are less optimal.
The nurse has reinforced teaching with a client who has anxiety and a new prescription for alprazolam. Which of the following statements by the client would indicate a correct understanding of the teaching?
- A. I can continue to take my prescribed muscle relaxant as needed.
- B. I can omit the medication on days when I do not feel anxious.
- C. I should eliminate aged cheese and processed meats from my diet.
- D. I will discontinue the medication and notify my health care provider if I become pregnant.
Correct Answer: D
Rationale: Alprazolam is a benzodiazepine, and its use during pregnancy can pose risks to the fetus. Discontinuing and notifying the provider is critical. Muscle relaxants may enhance sedation, skipping doses disrupts therapeutic levels, and dietary restrictions like avoiding tyramine are not required for alprazolam.
The nurse is preparing teaching for a client with Parkinson disease. Which of the following techniques are appropriate when communicating with a client with Parkinson disease? Select all that apply.
- A. Encourage the client to speak slowly and pause to take deep breaths periodically
- B. Identify and promote the client's capabilities and strengths throughout the sessions
- C. Provide client teaching during times of day when the client has the most energy
- D. Reserve discussion of important or complex teaching for the client's caregiver
- E. Schedule teaching sessions at times with low risk of rushing or interruptions
Correct Answer: A,B,C,E
Rationale: Speaking slowly aids clarity, promoting strengths builds confidence, teaching during high-energy times optimizes learning, and uninterrupted sessions enhance focus. Complex teaching should include the client, not just the caregiver, to respect autonomy.
The nurse has reinforced teaching with the parent of a pediatric client with newly diagnosed hemophilia A. Which of the following statements by the parent would indicate a correct understanding of the teaching? Select all that apply.
- A. I should avoid using icepacks if my child is injured.
- B. I should provide a high-fat, high-protein diet for my child.
- C. My child should wear emergency medical identification at all times.
- D. My child can participate in noncontact sports such as swimming.
- E. I should avoid giving my child medication containing aspirin.
Correct Answer: C,D,E
Rationale: Medical identification ensures prompt treatment in emergencies. Noncontact sports like swimming are safe. Aspirin increases bleeding risk and should be avoided. Ice packs are beneficial for injuries to reduce swelling, and diet doesn't require high-fat/protein for hemophilia management.