Nokea
The nurse is reviewing teaching with the parents of a child who has tinea capitis (ringworm of the scalp) and is newly prescribed griseofulvin oral suspension and 1% selenium sulfide shampoo. Which statement by the child's parent requires the nurse to intervene?
- A. I will discontinue the griseofulvin once the ringworm stops itching and the scales go away.
- B. I will give the griseofulvin suspension to my child after consumption of high-fat food, like ice cream.
- C. I will monitor my child for increased sensitivity to sunlight while taking griseofulvin.
- D. I will wash my child's scalp a few times per week with the medicated shampoo.
Correct Answer: A
Rationale: Griseofulvin requires a full course (6-8 weeks) to eradicate tinea capitis, even if symptoms resolve, to prevent recurrence. High-fat foods enhance absorption, photosensitivity is a side effect, and shampoo use a few times weekly is appropriate.
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The nurse is reinforcing discharge teaching to several clients with new prescriptions. Which instructions by the nurse about medication administration are correct? Select all that apply.
- A. Avoid salt substitutes when taking valsartan for hypertension
- B. Take levofloxacin with an aluminum antacid to avoid gastric irritation
- C. Take sucralfate (for a gastric ulcer) after meals to minimize gastric irritation
- D. When taking ethambutol, notify the health care provider (HCP) for changes in vision
- E. When taking rifampin, notify the HCP if the urine turns red-orange in color
Correct Answer: A,D
Rationale: Salt substitutes (potassium-based) can cause hyperkalemia with valsartan. Ethambutol can cause optic neuritis, requiring vision change reports. Levofloxacin with antacids reduces absorption. Sucralfate is taken before meals to coat the stomach. Rifampin's red-orange urine is normal, not reportable.
The nurse in the outpatient clinic is speaking with a client diagnosed with cerebral arteriovenous malformation. Which statement would be a priority for the nurse to report to the health care provider?
- A. I got short of breath this morning when I worked out
- B. I have cut down on smoking to ½ pack per day
- C. I haven't been feeling well, so I have been sleeping a lot.
- D. I took an acetaminophen in the waiting room for this bad headache.
Correct Answer: D
Rationale: A bad headache in a client with cerebral arteriovenous malformation may indicate increased intracranial pressure or bleeding, requiring urgent reporting. Other symptoms are less specific and less immediately critical.
The nurse is reinforcing teaching about ulcer prevention with a client newly diagnosed with peptic ulcer disease. Which of the following client statements indicate appropriate understanding of teaching? Select all that apply.
- A. I need to avoid taking medicines like ibuprofen without a prescription.
- B. I should avoid drinking excess coffee or cola.
- C. I should enroll in a smoking cessation program.
- D. I should reduce or eliminate my intake of alcoholic beverages.
- E. I will eliminate whole wheat foods, like breads and cereals, from my diet.
Correct Answer: A,B,C,D
Rationale: Avoiding NSAIDs (ibuprofen), excess coffee/cola, smoking, and alcohol reduces ulcer irritation and promotes healing. Whole wheat foods are beneficial for digestion and not contraindicated.
An adult who has osteoarthritis tells the clinic nurse that her joints have been more painful lately and her head aches and her ears are 'making funny buzzing sounds.' What question should the nurse ask the client?
- A. How long have you had arthritis?
- B. Have you recently been exposed to loud noises?
- C. What do you think is causing your joints to hurt more lately?
- D. What medication have you been taking for your painful joints?
Correct Answer: D
Rationale: New symptoms with increased joint pain suggest possible medication side effects (e.g., NSAIDs causing tinnitus), making medication history critical.
A 6-month-old infant is being seen in the doctor's office. Which observation by the nurse should be brought to the physician's attention?
- A. The baby sits up but needs slight support.
- B. The baby was 7 lb at birth and now weighs 10 lb.
- C. The baby frequently drops objects and looks for them.
- D. The baby smacks her lips and drools.
Correct Answer: B
Rationale: A 6-month-old should double birth weight (14 lb expected for 7 lb); 10 lb suggests poor growth, requiring evaluation. Other findings are developmentally normal.