Nokea
The nurse is teaching a client about newly prescribed isoniazid (INH) for pulmonary tuberculosis. Which of the following statements by the client would require follow up?
- A. I will have to take this medication for three months.
- B. I will need to have my blood drawn periodically to see if I am having an adverse effect to this medication.
- C. I will not be considered infectious if I have three consecutive negative sputum samples.
- D. This medication may make my hands and feet have numbness and tingling sensations.
Correct Answer: A
Rationale: Choice A requires follow-up because isoniazid (INH) treatment for pulmonary tuberculosis typically lasts 6-9 months, not 3 months. Choice B is correct; periodic blood tests monitor for hepatotoxicity. Choice C is correct; three consecutive negative sputum samples indicate non-infectiousness. Choice D is correct; INH can cause peripheral neuropathy, manifesting as numbness and tingling.
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An 82-year-old female has several ecchymotic areas on her left arm. The nurse should further assess the client for:
- A. Elder abuse.
- B. Self-inflicted injury.
- C. Increased capillary fragility and permeability.
- D. Increased blood supply to the skin.
Correct Answer: C
Rationale: Aging increases capillary fragility and permeability, leading to easy bruising (ecchymosis). While elder abuse is possible, capillary fragility is the most likely cause in this context.
A client with a spinal cord injury is at risk for pressure ulcers. Which nursing intervention is most effective?
- A. Reposition the client every 4 hours.
- B. Use a foam mattress without a cover.
- C. Apply lotion to bony prominences daily.
- D. Turn the client every 2 hours.
Correct Answer: D
Rationale: Turning every 2 hours redistributes pressure, preventing ulcer formation in immobilized clients.
The nurse is caring for a client reporting an abrupt onset of severe pain associated with metastatic cancer. Which prescription should the nurse plan to administer?
- A. fentanyl via transdermal patch
- B. pregabalin
- C. ketorolac
- D. hydromorphone
Correct Answer: D
Rationale: Hydromorphone is appropriate for rapid relief of severe, acute cancer pain due to its fast-acting opioid properties.
A client is being monitored for transient ischemic attacks. She is oriented, can open her eyes spontaneously, and follows commands. What is her Glasgow Coma Scale score?
Correct Answer: 15
Rationale: The Glasgow Coma Scale assesses eye opening (4 for spontaneous), verbal response (5 for oriented), and motor response (6 for following commands). The client's score is 4 + 5 + 6 = 15.
A client is admitted for a revascularization procedure for arteriosclerosis in his left iliac artery. To promote circulation in the extremities, the nurse should:
- A. Position the client on a firm mattress
- B. Keep the involved extremity warm with blankets
- C. Position the left leg at or below the body's horizontal plane
- D. Encourage the client to raise and lower his leg four times every hour
Correct Answer: C
Rationale: Positioning the left leg at or below the body's horizontal plane promotes arterial blood flow to the extremity in arteriosclerosis, avoiding gravitational resistance. A firm mattress is irrelevant, warmth is beneficial but secondary, and leg raises may not be feasible pre-revascularization.