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The nurse is reviewing discharge prescriptions for a child postoperative following a tonsillectomy. Which medication requires clarification with the primary healthcare provider?
- A. tetracaine 0.5% lollipop
- B. acetaminophen (APAP)
- C. ibuprofen
- D. codeine
Correct Answer: D
Rationale: Codeine is not recommended for children post-tonsillectomy due to risks of respiratory depression, especially in those with undiagnosed sleep apnea or ultra-rapid metabolism.
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When beginning I.V. erythropoietin (Epogen, Procrit) therapy, the nurse should do which of the following? Select all that apply.
- A. Checking the hemoglobin levels before administering subsequent doses.
- B. Shaking the vial thoroughly to mix the concentrated white, milky solution.
- C. Keeping the multidose vial refrigerated between scheduled twice-a-day doses.
- D. Administering the medication through the I.V. line without other medications.
- E. Adjusting the initial doses according to the client's changes in blood pressure.
- F. Educating the client to avoid driving and performing hazardous activity during the initial treatment.
Correct Answer: A,C,D,F
Rationale: For IV erythropoietin therapy, the nurse should check hemoglobin levels to monitor response and prevent overcorrection, keep multidose vials refrigerated to maintain stability, administer without mixing with other medications to avoid interactions, and educate about avoiding hazardous activities due to potential side effects like dizziness. Shaking the vial can denature the protein, and dose adjustments are typically based on hematologic response, not blood pressure.
The client asks the nurse to explain what it means that his Hodgkin's disease is diagnosed at stage 1A. Which of the following describes the involvement of the disease?
- A. Involvement of a single lymph node.
- B. Involvement of two or more lymph nodes on the same side of the diaphragm.
- C. Involvement of lymph node regions on both sides of the diaphragm.
- D. Diffuse disease of one or more extralymphatic organs.
Correct Answer: A
Rationale: Stage 1A Hodgkin's disease indicates involvement of a single lymph node region without B symptoms (fever, night sweats, weight loss). Higher stages involve multiple nodes or extralymphatic sites.
A client with uric acid stones is prescribed a low-purine diet. Which food is allowed?
- A. Liver.
- B. Chicken.
- C. Apples.
- D. Sardines.
Correct Answer: C
Rationale: Apples are low in purines, suitable for a uric acid stone diet.
The nurse is preparing to administer a unit of packed red blood cells (PRBCs). The nurse should
- A. obtain a bag of 250 mL of 0.9% saline.
- B. obtain a bag of 250 mL of Dextrose 5% in water (D5W).
- C. insert a 22 gauge intravenous (IV) catheter.
- D. initiate continuous telemetry monitoring.
Correct Answer: A
Rationale: 0.9% saline is required to prime the tubing for PRBC transfusions, as it is compatible and prevents hemolysis. D5W causes hemolysis, a 22-gauge catheter is too small for blood products, and telemetry is not routinely required.
The nurse is conducting discharge education with a client newly diagnosed with Addison's disease. Which information should be included in the client and family teaching plan? Select all that apply.
- A. Addison's disease will resolve over a few weeks, requiring no further treatment.
- B. Avoiding stress and maintaining a balanced lifestyle will minimize risk for exacerbations.
- C. Fatigue, weakness, dizziness, and mood changes need to be reported to the physician.
- D. A medical identification bracelet should be worn.
- E. Family members need to be informed about the warning signals of adrenal crisis.
- F. Dental work or surgery will require adjustment of daily medication.
Correct Answer: B,C,D,E,F
Rationale: Addison's is chronic, requiring lifelong management. Stress management, symptom reporting, medical ID, family education, and medication adjustments for procedures are critical.