Nokea
The nurse is talking with a client with acne vulgaris who has a new prescription for isotretinoin. Which of the following statements by the client would require follow-up?
- A. I will take an oral contraceptive and use condoms while taking isotretinoin.
- B. I need to wear sunscreen and sun-protective clothing while outdoors.
- C. I will take a vitamin A supplement daily while taking isotretinoin.
- D. I should avoid drinking alcohol while taking the medication.
Correct Answer: C
Rationale: Vitamin A supplements can increase the risk of toxicity with isotretinoin, which is a vitamin A derivative.
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An adult is admitted with a possible detached retina. Which findings would the nurse expect during the admission assessment?
- A. The client says, 'My eye is very painful.'
- B. The client complains of a blank area in the visual field.
- C. The client says he sees halos around lights.
- D. The client says he cannot see anything that is not right in front of him.
Correct Answer: B
Rationale: Detached retina causes a visual field defect, like a blank area or curtain, due to retinal separation, unlike pain, halos (glaucoma), or tunnel vision.
The nurse is discussing management of nocturnal enuresis with the parent of a 10-year-old client who has had little response to behavioral interventions. The parent tells the nurse, 'My child wants to go to overnight camp in several months but is afraid of being teased by other children if an accident occurs.' Which of the following responses would be most appropriate for the nurse to make?
- A. The condition will be resolved by then if you are consistent with bedtime routines.
- B. We can ask your child's health care provider about trying a medication that may be helpful.
- C. You could offer to send disposable training pants for your child to wear if needed.
- D. You should consider sending your child to day camp instead of overnight camp.
Correct Answer: B
Rationale: Medications like desmopressin may help manage enuresis for events like camp, addressing the child's concerns.
The nurse is caring for a client who had a surgical excision and biopsy of a tumor. The biopsy results show that the tumor is malignant, but the client has not yet been informed by the health care provider. The client asks the nurse, 'Am I going to die?' Which of the following responses would be appropriate for the nurse to make?
- A. You seem upset. Tell me more about how you are feeling about this situation.
- B. I understand that you feel anxious. Maybe watching television will help you relax.
- C. Waiting for test results can be very stressful. I am sure that it will all work out.
- D. The biopsy results show that you have cancer. However, many cancers are treatable.
Correct Answer: A
Rationale: Exploring the client's feelings is supportive and appropriate, as the nurse should not disclose results before the provider.
Which of the following signs is highly suggestive of impaired hearing in an infant?
- A. The absence of the Moro reflex
- B. The absence of babbling by age 7 months
- C. A lack of eye contact when spoken to
- D. A lack of hand gesture to indicate wants
Correct Answer: B
Rationale: Absence of babbling by 7 months is a red flag for hearing impairment, as infants typically begin vocalizing in response to sounds. Other signs are less specific to hearing.
Which tasks are appropriate for the nurse in a long-term care unit to delegate to unlicensed assistive personnel? Select all that apply.
- A. Assign lunch times to other unlicensed assistive personnel on the unit
- B. Assist a client with bathing and changing an ostomy appliance
- C. Collect vital signs on a client newly arrived on the unit
- D. Pick up a prescribed oral antibiotic from the pharmacy
- E. Record intake and output for a client with chronic neurogenic bladder
Correct Answer: C,E
Rationale: Collecting vital signs and recording intake/output are within the scope of unlicensed assistive personnel. Other tasks require nursing judgment or are outside their scope.