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The nurse is talking with the parent of a 2-year-old client who has a sunburn across the back and shoulders. Which of the following statements by the parent would indicate a correct understanding of sunburn care? Select all that apply.
- A. I will encourage my child to drink extra fluids.
- B. I will give my child aspirin to help relieve pain.
- C. I can allow my child to play outdoors with adequate sun protection.
- D. I can place cool compresses on my child's back to decrease discomfort
- E. I will apply hydrocortisone cream to the affected area and cover it with gauze dressings.
Correct Answer: A,C,D
Rationale: Extra fluids prevent dehydration, cool compresses soothe skin, and outdoor play with protection (sunscreen, clothing) is safe. Aspirin is avoided in children due to Reye's syndrome risk. Hydrocortisone isn't standard for sunburn; aloe or moisturizers are preferred.
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The nurse is reinforcing education to a group of clients who are pregnant or planning pregnancy. Which of the following client statements about alcohol use in pregnancy indicate a need for further education? Select all that apply.
- A. As long as I don't binge drink, an occasional glass of wine is fine.
- B. I drank alcohol heavily before realizing I was pregnant, so there is no benefit to quitting now.
- C. If I drink alcohol, my baby may have withdrawal after birth but no permanent damage.
- D. It is important to stop drinking while I am trying to conceive.
- E. Third-trimester alcohol use is less harmful because the baby is fully developed.
Correct Answer: A,B,C,E
Rationale: No amount of alcohol is safe during pregnancy, as it can cause fetal alcohol spectrum disorders. Quitting at any point reduces harm. Alcohol can cause permanent damage, not just withdrawal. Third-trimester exposure still risks brain development. Stopping preconception is correct.
The nurse is reviewing the medical record for an adolescent client with major depressive disorder. Which of the following findings would be consistent with the condition? Select all that apply.
- A. often sleeps during class or after-school activities
- B. has received disciplinary action at school due to absenteeism and angry outbursts
- C. has unintentionally lost 8 lb (3.6 kg) over the past 3 weeks
- D. abruptly quit playing sports despite receiving previous athletic awards and trophies
- E. voices concern about the appearance of acne on the face
Correct Answer: A,B,C,D
Rationale: Excessive sleep, irritability (outbursts), weight loss, and loss of interest in activities (quitting sports) are hallmarks of depression. Acne concern is typical adolescent behavior, not specific to depression.
The licensed practical nurse is working with a registered nurse to care for a client who has just returned to the cardiac unit after having a percutaneous coronary intervention. Which actions assigned by the registered nurse should the practical nurse question as outside of the practical nurse's scope of practice? Select all that apply.
- A. Administering oral pain medication if client reports low back pain
- B. Checking for bleeding at the catheter insertion site every 15 minutes
- C. Performing post-procedure vital sign measurements
- D. Reinforcing instructions to keep the involved extremity straight
- E. Reviewing ECG for dysrhythmias
Correct Answer: E
Rationale: Reviewing ECGs for dysrhythmias requires advanced assessment skills beyond LPN scope. Administering medication, checking for bleeding, taking vital signs, and reinforcing instructions are within LPN scope if trained.
The nurse has reinforced teaching with a client who has anxiety and a new prescription for alprazolam. Which of the following statements by the client would indicate a correct understanding of the teaching?
- A. I can continue to take my prescribed muscle relaxant as needed.
- B. I can omit the medication on days when I do not feel anxious.
- C. I should eliminate aged cheese and processed meats from my diet.
- D. I will discontinue the medication and notify my health care provider if I become pregnant.
Correct Answer: D
Rationale: Alprazolam is a benzodiazepine, and its use during pregnancy can pose risks to the fetus. Discontinuing and notifying the provider is critical. Muscle relaxants may enhance sedation, skipping doses disrupts therapeutic levels, and dietary restrictions like avoiding tyramine are not required for alprazolam.
The nurse evaluating a 52-year-old diabetic male client's therapeutic response to rosuvastatin would notice changes in which laboratory values? Select all that apply.
- A. Alanine aminotransferase from 20 U/L (0.33 ukat/L) to 80 U/L (1.34 ukat/L)
- B. High-density lipoprotein cholesterol from 48 mg/dL (1.24 mmol/L) to 30 mg/dL (0.78 mmol/L)
- C. Low-density lipoprotein cholesterol from 176 mg/dL (4.61 mol/L) to 98 mg/dL (2.54 mmol/L)
- D. Total cholesterol from 250 mg/dL (6.47 mmol/L) to 180 mg/dL (4.66 mmol/L)
- E. Triglycerides from 180 mg/dL (2.03 mmol/L) to 149 mg/dL (1.68 mmol/L)
Correct Answer: C,D,E
Rationale: Rosuvastatin, a statin, is expected to lower LDL cholesterol, total cholesterol, and triglycerides, indicating therapeutic response. An increase in alanine aminotransferase suggests liver stress, which is a side effect to monitor, not a therapeutic goal. A decrease in HDL cholesterol is undesirable, as statins typically maintain or increase HDL.