Nokea
The nurse is teaching a client about isoniazid (INH). Which of the following statements should the nurse include?
- A. This medication may turn your secretions reddish/orange.
- B. Yellowing of your eyes is a normal side-effect.
- C. A B-complex vitamin should be taken to help with the neuropathy.
- D. This medication will need to be taken every day for at least one week.
Correct Answer: C
Rationale: Isoniazid (INH) can cause peripheral neuropathy, and a B-complex vitamin (especially vitamin B6) is often recommended to help prevent or manage this side effect. Choice A is incorrect because reddish/orange secretions are associated with rifampin, not INH. Choice B is incorrect because yellowing of the eyes (jaundice) is a sign of hepatotoxicity, a serious adverse effect, not a normal side effect. Choice D is incorrect because INH treatment for tuberculosis typically lasts 6-9 months, not just one week.
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A female client who has a urinary diversion tells the nurse, 'This urinary pouch is embarrassing. Everyone will know that I'm not normal. I don't see how I can go out in public anymore.' The most appropriate nursing diagnosis for this client is:
- A. Anxiety related to the presence of a urinary diversion.
- B. Deficient knowledge about how to care for the urinary diversion.
- C. Low self-esteem related to feelings of worthlessness.
- D. Unstuffed body image related to creation of a urinary diversion.
Correct Answer: D
Rationale: The client's statement reflects distress about the urinary diversion's impact on her appearance and social life, indicating a disturbed body image.
The nurse is assessing a client with a recent history of an above-the-knee amputation presenting with phantom limb pain. The nurse anticipates a prescription for
- A. aripiprazole
- B. oxycodone
- C. amitriptyline
- D. hydroxyzine
Correct Answer: C
Rationale: Amitriptyline, a tricyclic antidepressant, is commonly used for neuropathic pain, including phantom limb pain, due to its effects on nerve signaling.
A client on peritoneal dialysis reports cloudy effluent. The nurse should:
- A. Continue the exchange.
- B. Notify the physician.
- C. Increase dwell time.
- D. Administer pain medication.
Correct Answer: B
Rationale: Cloudy effluent suggests peritonitis, requiring immediate medical attention.
The nurse is reviewing the postoperative orders (see chart) just written by a physician for a client with insulin-dependent diabetes who has returned to the surgery floor from the recovery. The client has pain of 5 on a scale of 1 to 10. The hand-off report from the nurse in the recovery room indicated that the vital signs have been stable for the last 30 minutes. After obtaining the client's glucose level, the nurse should do which of the following first?
- A. Administer the morphine.
- B. Contact the physician to report the glucose level and rewrite the insulin order.
- C. Administer oxygen per nasal cannula at 2 L/minute.
- D. Take the vital signs.
Correct Answer: B
Rationale: The glucose level must be assessed to determine if insulin is safe to administer, as hypoglycemia could worsen with insulin. Contacting the physician ensures appropriate insulin dosing.
The client with vasospastic disorder (Raynaud's phenomenon) complains of cold and numbness in her fingers. The nurse assesses the client for effects of vasoconstriction. Which of the following is an early sign of vasoconstriction?
- A. Cyanosis
- B. Gangrene
- C. Pallor
- D. Rubor
Correct Answer: C
Rationale: Pallor is an early sign of vasoconstriction in Raynaud's, as reduced blood flow causes the skin to turn white. Cyanosis occurs later with prolonged ischemia, gangrene is a late complication, and rubor (redness) occurs during the hyperemic phase after vasospasm resolves.