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The nurse provides home care instructions to a client who has been diagnosed with recurrent trichomoniasis. The nurse determines the need for follow-up teaching if the client indicates she should take which action?
- A. Avoid sexual intercourse.
- B. Perform good perineal hygiene.
- C. Use the metronidazole as prescribed.
- D. Discontinue treatment during menstruation.
Correct Answer: D
Rationale: Treatment for a recurrent vaginal trichomoniasis infection continues through the menstrual period because the vagina is more alkaline during menses, and a flare-up is more likely to occur. While the infection remains active, the client should refrain from sexual intercourse or instruct her partner to wear a condom. To help break the chain of infection, the nurse directs the client to perform perineal hygiene after each voiding and each bowel movement. Metronidazole must be taken as prescribed.
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The mother of a child with celiac disease asks the nurse how long a special diet is necessary. The nurse provides which instruction to the mother to promote dietary compliance?
- A. A gluten-free diet will need to be followed for life.
- B. A lactose-free diet will need to be followed temporarily.
- C. Added dietary sodium will help prevent episodes of celiac crisis.
- D. Supplemental vitamins, iron, and folate will prevent complications.
Correct Answer: A
Rationale: Celiac disease is characterized by intolerance to gluten, the protein component of wheat, barley, rye, and oats. The main nursing consideration with celiac disease is helping the child adhere to dietary management. The treatment of celiac disease consists primarily of dietary management with a gluten-free diet. Options 2 and 4 are true statements, but they do not answer the question that the client is asking. Children with untreated celiac disease may have lactose intolerance, which usually improves with gluten withdrawal. Additional sodium does not prevent celiac crisis. Low levels of potassium, calcium, and magnesium are most likely to be present. Nutritional deficiencies resulting from malabsorption are treated with appropriate supplements.
The nurse is caring for a client with myasthenia gravis (MG) who is 14 weeks pregnant. Which of the following does the nurse understand about MG in the pregnant client?
- A. Most women with MG tolerate labor poorly unless they are in excellent physical health.
- B. Approximately 25% to 30% of neonates born to women with MG develop neonatal myasthenia.
- C. MG usually goes into remission with younger clients and causes exacerbation in older clients.
- D. Narcotics must be used with caution due to the risk of respiratory depression in clients who are already at risk for respiratory muscle weakness.
Correct Answer: B,D
Rationale: 25-30% of neonates may develop transient myasthenia, and narcotics require caution due to respiratory risks. Labor tolerance varies, and remission isn't age-dependent.
The nurse makes a home care visit to a client diagnosed with Bell's palsy. Which statement by the client indicates a need for further teaching?
- A. I wear an eye patch at night.
- B. I am staying on a liquid diet.
- C. I wear dark glasses when I go out.
- D. I have been gently massaging my face.
Correct Answer: B
Rationale: Bell's palsy is caused by a lower motor neuron lesion of the seventh cranial nerve that may result from infection, trauma, hemorrhage, meningitis, or tumor. It is not necessary for a client diagnosed with Bell's palsy to stay on a liquid diet. The client should be encouraged to chew on the unaffected side. Wearing an eye patch at night, dark glasses for daytime outings, and gently massaging the face identify accurate statements related to the management of Bell's palsy.
The nurse in an ambulatory clinic administers a tuberculin skin test to a client on a Monday. When should the nurse tell the client to return to the clinic to have the results read?
- A. Thursday or Friday
- B. The following Monday
- C. Tuesday or Wednesday
- D. Wednesday or Thursday
Correct Answer: D
Rationale: The tuberculin skin test for tuberculosis is read in 48 to 72 hours; therefore, the client should return to the clinic on Wednesday or Thursday.
A normal, healthy 35-year-old male client visits the doctor's office for a routine annual physical. When auscultating between the first and second interspaces on the anterior chest, the nurse anticipates which type of breath sound?
- A. bronchovesicular
- B. vesicular
- C. bronchial
- D. tracheal
Correct Answer: A
Rationale: Bronchovesicular sounds are expected between the first and second interspaces, where major bronchi and alveoli are near.