Nokea
The nurse should advise which of the following clients who is taking lithium to consult with the physician regarding a potential adjustment in lithium dosage?
- A. A client who continues work as a computer programmer.
- B. A client who attends college classes.
- C. A client who can now care for her children.
- D. A client who is beginning training for a tennis team.
Correct Answer: D
Rationale: Increased physical activity, such as tennis training, can lead to dehydration or electrolyte imbalances, which may affect lithium levels and increase toxicity risk, necessitating a dosage adjustment.
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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?
- A. Gingival hyperplasia.
- B. Weight gain.
- C. Insomnia.
- D. Dry skin.
Correct Answer: A
Rationale: Phenytoin commonly causes gingival hyperplasia, which should be reported to manage oral health and adjust treatment if needed.
The nurse is assessing a client with a suspected urinary tract infection. Which of the following symptoms is most likely to be present?
- A. Flank pain.
- B. Hypotension.
- C. Bradycardia.
- D. Dry skin.
Correct Answer: A
Rationale: Flank pain is a common symptom of a urinary tract infection, especially if it involves the kidneys.
An adult client has bacterial conjunctivitis. What should the nurse teach him to do? Select all that apply.
- A. Use warm saline soaks four times per day to remove crusting.
- B. Apply topical antibiotic without touching the tip of the tube to his eye.
- C. Wash his hands after touching his eyes.
- D. Avoid touching his eyes.
- E. Observe isolation procedures and confine himself to his bedroom until the redness in the eye disappears.
Correct Answer: A,B,C,D
Rationale: Warm saline soaks, careful antibiotic application, hand washing, and avoiding eye contact prevent spread and promote healing. Isolation is unnecessary unless specified.
The client received electroconvulsive therapy (ECT) an hour ago and tells the nurse that he has a headache. Which response by the nurse is best?
- A. A headache is common after ECT.
- B. I will get some acetaminophen (Tylenol) for you.
- C. A nap will help you feel better.
- D. A tapur command and then let me know how you feel.
Correct Answer: B
Rationale: Offering acetaminophen addresses the client's complaint directly and safely, as headaches are a common side effect of ECT. Informing the client that headaches are common does not provide relief, and a nap or unclear commands are not appropriate responses.
You are a registered nurse who is performing the role of a case manager in your hospital. You have been asked to present a class to newly employed nurses about your role, your responsibilities and how they can collaborate with you as the case manager. Which of the following is a primary case management responsibility associated with reimbursement that you should include in this class?
- A. The case manager's role in terms of organization wide performance improvement activities
- B. The case manager's role in terms complete, timely and accurate documentation
- C. The case manager's role in terms of the clients' being at the appropriate level of care
- D. The case manager's role in terms of contesting denied reimbursements
Correct Answer: C
Rationale: A primary case management responsibility related to reimbursement is ensuring that clients are at the appropriate level of care , which directly impacts reimbursement by ensuring services match medical necessity and payer requirements.