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The nurse is reviewing discharge instructions with a client going home on linezolid therapy for a vancomycin-resistant enterococcus infection. Which client statement requires further teaching?
- A. I can restart my paroxetine once I get back home.
- B. I can take acetaminophen for headaches.
- C. I will avoid foods and drinks that contain tyramine.
- D. I will report any increased fever or diarrhea.
Correct Answer: A
Rationale: Linezolid interacts with SSRIs like paroxetine, risking serotonin syndrome, requiring a washout period. Acetaminophen is safe, tyramine avoidance prevents hypertensive crises, and reporting fever/diarrhea monitors treatment response.
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An adult is admitted with Guillain-Barré syndrome. On day 3 of hospitalization, the client's muscle weakness worsens, and he is no longer able to stand with support. He is also having difficulty swallowing and talking. The priority in the nursing care plan at this time is to prevent which problem?
- A. Aspiration pneumonia
- B. Decubitus ulcers
- C. Bladder distention
- D. Hypertensive crisis
Correct Answer: A
Rationale: Difficulty swallowing increases aspiration risk, making aspiration pneumonia the priority. Other complications are secondary in this acute phase.
A client with ascites due to cirrhosis has increasing shortness of breath and abdominal pain and is scheduled for paracentesis. Which of the following nursing actions should be implemented prior to the procedure? Select all that apply.
- A. Ensure that informed consent has been obtained
- B. Place the client in reverse Trendelenburg position
- C. Place the client on NPO status
- D. Request the client empty their bladder
- E. Take baseline vital signs and weight
Correct Answer: A,D,E
Rationale: Informed consent ensures understanding, emptying the bladder prevents injury during needle insertion, and baseline vital signs/weight monitor fluid shifts. Reverse Trendelenburg is inappropriate; upright positioning is typical. NPO status isn't required for paracentesis.
A nursing assistant comes to the LPN/LVN and complains that she has more residents to care for than another nursing assistant (NA). She has one more resident assigned to her than the other NA. However, the other NA has more total care residents than the complaining NA. How should the LPN/LVN handle this situation?
- A. Tell the complaining NA that this is the assignment
- B. Promise to give her an easier assignment tomorrow
- C. Discuss with her the needs of her assignment and help her organize her care
- D. Tell her that the other NA will help her as needed
Correct Answer: C
Rationale: Discussing needs and organizing care addresses the NA's concerns constructively, promoting teamwork and efficiency without dismissing or deferring.
The spouse of a client calls the nurse at the clinic and reports that the client is not feeling well and is concerned that something is seriously wrong. How should the nurse respond initially?
- A. Ask the spouse to further describe the client's symptoms
- B. Indicate that privacy rules prevent discussion of concerns with the spouse
- C. Offer a same-day appointment to the client
- D. Tell the spouse to have the client call the nurse
Correct Answer: A
Rationale: Asking for symptom details helps assess urgency without violating privacy, as the spouse initiated contact. Privacy rules don't preclude initial fact-gathering, but direct client contact or an appointment may follow based on severity.
The nurse is assessing a 4 year-old for possible developmental dysplasia of the right hip. Which finding would the nurse expect?
- A. Pelvic tip downward
- B. Right leg lengthening
- C. Ortolani sign
- D. Characteristic limp
Correct Answer: D
Rationale: Characteristic limp. Developmental dysplasia produces a characteristic limp in children who are walking, indicating hip joint instability.