Nokea
The nurse is preparing to discharge a client who is taking an MAOI. The nurse should instruct the client to:
- A. Wear protective clothing and sunglasses when outside.
- B. Avoid over-the-counter cold and hay fever preparations.
- C. Drink at least eight glasses of water a day.
- D. Increase his intake of high-quality protein.
Correct Answer: B
Rationale: MAOIs interact with tyramine-containing OTC cold and allergy medications, risking hypertensive crisis. Sunglasses, hydration, and protein intake are not specific to MAOI precautions.
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The client is admitted with a diagnosis of preterm premature rupture of membranes (PPROM). The nurse should prepare to administer which medication?
- A. Magnesium sulfate
- B. Terbutaline
- C. Betamethasone
- D. All of the above
Correct Answer: C
Rationale: Betamethasone is administered in PPROM (24-34 weeks) to enhance fetal lung maturity in anticipation of preterm delivery. Magnesium sulfate may be used for neuroprotection or preeclampsia and terbutaline is a tocolytic but betamethasone is the priority.
The client is admitted with a diagnosis of vasa previa. Which delivery method is most likely to be planned?
- A. Vaginal delivery
- B. Cesarean section
- C. Forceps-assisted delivery
- D. Vacuum-assisted delivery
Correct Answer: B
Rationale: Vasa previa with fetal vessels crossing the cervical os requires cesarean section to prevent vessel rupture and fetal exsanguination during vaginal delivery. Forceps or vacuum delivery increases risk.
A client with a history of a stroke is being discharged. The nurse should teach the client to:
- A. Avoid all physical activity
- B. Use assistive devices as needed
- C. Limit social interactions
- D. Eat a high-sodium diet
Correct Answer: B
Rationale: Assistive devices (e.g., cane, walker) promote safety and mobility post-stroke. Physical activity is encouraged, social interactions are beneficial, and sodium should be limited.
Before administering eardrops to a toddler,the nurse should recognize that it is essential to consider which of the following?
- A. Age
- B. Weight
- C. Developmental level
- D. Ability to understand
Correct Answer: C
Rationale: The toddler’s developmental level affects cooperation and ability to follow instructions during eardrop administration. Age is a factor but less specific and weight or understanding are secondary to developmental considerations.
To prevent fungal infections of the mouth and throat, the nurse should teach clients on inhaled steroids to:
- A. Rinse the plastic holder that aerosolizes the drug with hydrogen peroxide every other day
- B. Rinse the mouth and gargle with warm water after each use of the inhaler
- C. Take antacids immediately before inhalation to neutralize mucous membranes and prevent infection
- D. Rinse the mouth before each use to eliminate colonization of bacteria
Correct Answer: B
Rationale: It is sufficient to rinse the plastic holders with warm water at least once per day. It is important to rinse the mouth after each use to minimize the risk of fungal infections by reducing the droplets of the glucocorticoid left in the oral cavity. Antacids act by neutralizing or reducing gastric acid, thus decreasing the pH of the stomach. 'Neutralizing' the oral mucosa prior to inhalation of a steroid inhaler does not minimize the risk of fungal infections. Rinsing prior to the use of the glucocorticoid will not eliminate the droplets left on the oral mucous membranes following the use of the inhaler.