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The nurse is teaching a client with a new diagnosis of epilepsy about lamotrigine (Lamictal). Which of the following statements by the client indicates a need for further teaching?
- A. I should report a rash to my doctor.
- B. I should take this medication at the same time each day.
- C. I should avoid drinking alcohol.
- D. I should stop this medication if my seizures stop.
Correct Answer: D
Rationale: Stopping lamotrigine when seizures stop is incorrect, as epilepsy often requires lifelong treatment to prevent recurrence. Options A, B, and C are correct: rash may indicate Stevens-Johnson syndrome, consistent timing ensures steady levels, and alcohol increases sedation.
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The physician prescribes lithium carbonate (Lithobid) 300 mg PO QID for a 47-year-old woman. The nurse in the outpatient clinic teaches the client about the medication. The nurse should encourage the client to make sure her diet has adequate
- A. sodium.
- B. protein.
- C. potassium.
- D. iron.
Correct Answer: A
Rationale: alkali metal salt acts like sodium ions in body; excretion of lithium depends on normal sodium levels; sodium reduction causes marked lithium retention, leading to toxicity
The parents of a one-month-old boy bring their son to the clinic for evaluation of a possible right dislocated hip.
- A. Which symptom will the nurse observe in a one-month-old with unilateral right hip dislocation?
- B. Limited adduction of the right leg.
- C. Uneven gluteal fold and thigh creases.
- D. Increase in length of the right limb.
- E. Internal rotation of the right leg.
Correct Answer: B
Rationale: Unilateral hip dislocation causes uneven gluteal folds and thigh creases, with deeper and longer folds on the affected side due to hip displacement. Limited abduction (not adduction), shortened limb length, and variable rotation are more typical findings.
A client with chronic bronchitis is admitted with complaints of chest pain. Which of the following drug orders should the nurse question?
- A. Nitroglycerin (Nitrostat)
- B. Cephalexin (Keflex)
- C. Propranolol (Inderal)
- D. Verapamil (Calan)
Correct Answer: C
Rationale: Propranolol, a beta-blocker, can exacerbate bronchoconstriction in chronic bronchitis, worsening respiratory symptoms. Nitroglycerin, cephalexin, and verapamil are less likely to pose issues in this context.
The nurse is teaching a client with a new diagnosis of atrial fibrillation about diltiazem (Cardizem). Which of the following instructions should the nurse include?
- A. Take the medication with grapefruit juice.
- B. Report any swelling in the legs.
- C. Stop the medication if heart rate normalizes.
- D. Avoid checking pulse rate.
Correct Answer: B
Rationale: Swelling in the legs may indicate heart failure, requiring reporting. Options A, C, and D are incorrect.
The nurse is caring for a client who is postoperative day 1 after a nephrectomy. Which of the following findings should the nurse report immediately?
- A. Pain at the incision site.
- B. Temperature of 100.8°F (38.2°C).
- C. Urine output of 30 mL/hour.
- D. Blood pressure of 130/80 mmHg.
Correct Answer: B
Rationale: A temperature of 100.8°F suggests infection, a serious post-nephrectomy complication. Options A, C, and D are normal or expected.