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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When making a home visit to a client with chronic pyelonephritis, which nursing action has the highest priority?
- A. Follow-up on lab values before the visit
- B. Observe client findings for the effectiveness of antibiotics
- C. Ask for a log of urinary output
- D. Ask for the log of the oral intake
Correct Answer: C
Rationale: Ask for a log of urinary output. Monitoring urine output is the best indicator of renal function in pyelonephritis.
The nurse is caring for a client who has a prescription for insulin lispro 1 unit subcutaneously per 15 g of carbohydrates with each meal. The client's meal contains 75 g of carbohydrates. How many units of insulin lispro should the nurse administer to the client? Record your answer using a whole number.
Correct Answer: 5
Rationale: 75 g carbohydrates ÷ 15 g/unit = 5 units of insulin lispro.
The nurse is teaching a client with atrial fibrillation about the use of Coumadin (warfarin) at home. The need to avoid which of these should be emphasized to the client?
- A. Large indoor gatherings
- B. Exposure to sunlight
- C. Active physical exercise
- D. Foods rich in vitamin K
Correct Answer: D
Rationale: Foods rich in vitamin K. Vitamin K acts as an antidote to the pharmacologic action of Coumadin therapy, decreasing Coumadin's effectiveness. Foods high in vitamin K include dark greens, tomatoes, bananas, cheese, and fish.
The nurse is caring for a client who underwent a transsphenoidal hypophysectomy to remove a pituitary adenoma. Which of the following interventions should the nurse implement? Select all that apply.
- A. Encourage frequent coughing to prevent pneumonia
- B. Inspect the mouth and perform mouth care every 4 hours
- C. Maintain the head of the bed in a flat position
- D. Perform frequent neurologic checks
- E. Remind the client to avoid using a toothbrush for 10 days
Correct Answer: B,D,E
Rationale: Mouth care prevents infection, neurologic checks monitor for complications (e.g., CSF leak), and avoiding toothbrushing prevents suture disruption. Coughing risks increasing intracranial pressure, and the head of the bed should be elevated to reduce pressure.
The nurse is caring for a client with partial hearing loss. Which of the following actions will promote effective communication? Select all that apply.
- A. Dim lights to prevent overstimulation
- B. Directly face the client when speaking
- C. Ensure hearing aids are properly applied
- D. Provide written information to supplement conversation
- E. Raise voice to speak loudly to the client
Correct Answer: B,C,D
Rationale: Facing the client aids lip-reading, properly applied hearing aids optimize hearing, and written information reinforces verbal communication. Dimming lights may hinder lip-reading, and shouting distorts speech.