Nokea
The nurse is preparing to care for the 14-month-old newly hospitalized toddler with bacterial gastroenteritis and severe dehydration. Which initial collaborative interventions should the nurse expect to implement? Select all that apply.
- A. IV antibiotic to treat infection
- B. Oral fluids for fluid rehydration
- C. IV fluid therapy for rehydration
- D. Analgesics for pain and discomfort
- E. An antidiarrheal to control diarrhea
- F. Antipyretic for elevated temperature
Correct Answer: A,C,F
Rationale: A: Antibiotics may be prescribed to treat bacterial gastroenteritis to ensure complete recovery. B: Oral fluid rehydration will be initiated later, but not initially, when the toddler presents with severe dehydration. C: The child who presents with severe dehydration needs IV therapy to stabilize the balance of fluids and electrolytes. D: The pain and discomfort the toddler will have are due to fever and cramping from the GI illness; thus, analgesics are usually not prescribed. E: An antidiarrheal medication is contraindicated. F: Fever is often a symptom of gastroenteritis. Ensuring that the fever is controlled will provide some comfort.
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The LPN is teaching a 25-year-old client about HPV. Which statements made by the client indicate understanding of the teaching? Select all that apply.
- A. I can only get HPV if my boyfriend has symptoms.
- B. HPV can cause cancers later in life, which is why it is important to prevent it now.
- C. I feel a bit better about having HPV now that I know that almost all sexually active people have it at some point.
- D. It's a bummer that I'm too old for the vaccine.
- E. If I take my birth control diligently, I can significantly reduce my risk for HPV.
Correct Answer: B
Rationale: HPV infection is common and most adults will have HPV at some point in their life. It can be transmitted via skin-to-skin contact as well through vaginal, anal, or oral sex. HPV infections can cause cancer, though most infections will disappear within two years. Transmission of HPV can occur even if someone is not symptomatic of infection. The HPV vaccine is recommended for children age 9 up to adults age 26. The only way to help prevent sexual transmission of HPV between partners is with condom use.
Trimethoprim-sulfamethoxazole is prescribed for the child who develops a UTI. What information should the nurse address when teaching the parents about administering the medication? Select all that apply.
- A. Weigh the child daily in the morning.
- B. Take the child's temperature once daily.
- C. Encourage the child to drink plenty of fluids.
- D. Administer the medication at the prescribed times.
- E. If a rash occurs, report this immediately to the HCP.
Correct Answer: C,D,E
Rationale: A: Weighing is unnecessary; it is important with medications that affect fluid balance, but not with an antibiotic. B: Monitoring temperature would be important to evaluate the effectiveness of antipyretic medications. C: Fluids should be increased to dilute bacterial toxins and increase urinary output. D: The medication should be given in the exact amount at the times directed to maintain a therapeutic blood level. If the therapeutic blood level falls, organisms can build a resistance to the medication. E: Trimethoprim-sulfamethoxazole (Bactrim) is a sulfonamide antibiotic. A rash can indicate an allergy to sulfonamides.
The nurse is reviewing documentation on four clients prior to administering medications. The nurse should immediately withhold the medication and notify the HCP about which client?
- A. Client 1
- B. Client 2
- C. Client 3
- D. Client 4
Correct Answer: D
Rationale: Client 4's symptoms of tardive dyskinesia (lip smacking, uncontrolled rhythmic movements) may be irreversible, requiring immediate medication withdrawal and HCP notification.
The HCP prescribes risperidone to manage the hallucinations of the client diagnosed with paranoid schizophrenia. Which client statements reflect a need for further education regarding the medication's side effects? Select all that apply.
- A. Diarrhea may be a problem for me.
- B. I'll most likely develop high blood pressure.
- C. Being too nervous is a side effect of my medicine.
- D. I will need to watch what I eat so I won't gain weight.
- E. Getting up too quickly when I'm sitting can make me dizzy.
- F. I will need to be careful driving because this can make me drowsy.
Correct Answer: A,B
Rationale: Constipation, not diarrhea, and hypotension, not hypertension, are side effects of risperidone, indicating a need for further education.
The unresponsive client with DM is admitted to the ED with a serum glucose level of 35 mg/dL. Which medication should the nurse plan to administer?
- A. Exenatide
- B. Pramlintide
- C. Miglitol
- D. Glucagon
Correct Answer: D
Rationale: A: Exenatide (Byetta), a synthetic incretin mimetic, is used as an adjunct in type 2 diabetes to decrease blood glucose levels. B: Pramlintide (Symlin) lowers postprandial glucose levels by slowing gastric emptying. C: Miglitol (Glyset), an alpha-glucosidase inhibitor, lowers postprandial serum glucose levels. D: The nurse should plan to administer glucagon (GlucaGen). Glucagon, administered intramuscularly, intravenously, or subcutaneously, is used in unconscious clients with diabetes to reverse severe hypoglycemia from insulin overdose. Normal serum glucose is 70 to 110 mg/dL.