Nokea
The nurse is teaching a client with a new diagnosis of hyperthyroidism about medication management. Which of the following medications should the client expect to take?
- A. Methimazole.
- B. Levothyroxine.
- C. Liothyronine.
- D. Propylthiouracil.
Correct Answer: A, D
Rationale: Methimazole and propylthiouracil inhibit thyroid hormone production in hyperthyroidism.
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During the health history interview, which of the following strategies is the most effective for the nurse to use to help clients feel that they have an active role in their health care?
- A. Ask clients to complete a questionnaire.
- B. Provide clients with written instructions.
- C. Ask clients for their description of events and for their views concerning past medical care.
- D. Ask clients if they have any questions.
Correct Answer: C
Rationale: Engaging clients by asking for their description of events and views on past medical care promotes active participation, fosters trust, and ensures the nurse understands the client's perspective, which is critical for patient-centered care.
Which actions should the nurse implement to prevent ventilator-associated pneumonia (VAP) in the client who is intubated and on mechanical ventilation?
- A. Practice meticulous hand hygiene.
- B. Maintain the head of the bed elevation at 10 degrees.
- C. Perform suctioning of oral cavity secretions every 4 hours.
- D. Have the respiratory therapist change the ventilator circuit tubing every 4 hours.
Correct Answer: A
Rationale: Because normal upper airway defenses are bypassed, clients who are intubated with mechanical ventilation are at risk for VAP. Prevention includes effective hand washing before and after suctioning, when touching ventilator equipment, and when in contact with respiratory secretions. To prevent aspiration of colonized secretions from the oral cavity, the client will need more frequent oral cavity suctioning and at least 30 degrees head of the bed elevation. The more frequently the circuit is broken, the greater the risk for pathogen entry.
A client with a history of seizures is prescribed phenytoin (Dilantin). The nurse should instruct the client to report which of the following side effects immediately?
- A. Nausea.
- B. Gingival hyperplasia.
- C. Rash.
- D. Drowsiness.
Correct Answer: C
Rationale: A rash may indicate a serious hypersensitivity reaction to phenytoin, such as Stevens-Johnson syndrome, requiring immediate reporting.
A 62-year-old client with a 29-pack per year history is admitted with a diagnosis of the blood pressure. She reports having 'no appetite' and exhibits symptoms of anorexia. The client is 5 feet, 8 inches tall and weighs 112 lb. The client is now scheduled for a left lung lobectomy. Which of the following increases the client's risk of developing postoperative pulmonary complications?
- A. The client tends to keep her real feelings to herself.
- B. The client ambulates and can climb one flight of stairs without dyspnea.
- C. The client is age 62.
- D. The client is 5 feet, 8 inches tall and weighs 112 lb.
Correct Answer: D
Rationale: Low body weight (112 lb for 5'8') indicates malnutrition, increasing the risk of postoperative pulmonary complications.
The nurse notes that the primary health care provider has written a prescription for prednisone for a client. The nurse contacts the primary health care provider about revision of the client's medication plan if which medication is noted on the client's medication record?
- A. Furosemide
- B. Oxycodone
- C. Acetaminophen
- D. Acetylsalicylic acid
Correct Answer: D
Rationale: Prednisone, a glucocorticoid, is irritating to the gastrointestinal (GI) tract, which could be worsened by the use of other products that have the same side effect. Therefore, products such as aspirin (acetylsalicylic acid) and nonsteroidal antiinflammatory drugs are not used during corticosteroid therapy.