Nokea
The nurse teaches the client with relapsing-remitting MS about glatiramer. Which information addressed by the client indicates that the nurse's teaching has been effective? Select all that apply.
- A. Keep the medication vial refrigerated until it is to be used.
- B. Glatiramer is given by injection into the subcutaneous tissue.
- C. Rotate injection sites and wait a week before using a site again.
- D. The thigh and abdomen are the best subcutaneous injection sites.
- E. Syringes are washed, air dried, and reused until the needle is dull.
Correct Answer: A,B,C
Rationale: A: Glatiramer is used to delay the progression of MS. To maximize the therapeutic effects of glatiramer, it should be refrigerated and reconstituted correctly. B: Glatiramer is only administered subcutaneously; accidental IV administration must be avoided. C: Injection sites are rotated to prevent skin breakdown or lumps at the injection sites. D: Appropriate subcutaneous injection sites for glatiramer include the thigh, back of the hip, abdomen, and upper arm. E: Used syringes should be placed in a puncture-resistant container for proper disposal. Syringes and needles should not be reused.
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Which of the following injuries, if demonstrated by a client entering the Emergency Department, is the highest priority?
- A. open leg fracture
- B. open head injury
- C. stab wound to the chest
- D. traumatic amputation of a thumb
Correct Answer: C
Rationale: A stab wound to the chest might result in lung collapse and mediastinal shift that, if untreated, could lead to death. Treatment of an obstructed airway or a chest wound is a higher priority than hemorrhage. The principle of ABC (airway, breathing, and circulation) prioritizes care decisions.
The client with advanced prostate cancer is receiving abarelix. Due to the effects of the medication, what should be the nurse's priority?
- A. Review with the client strategies to reduce constipation.
- B. Monitor the client for breast tenderness and nipple pain.
- C. Observe the client for 30 minutes after giving abarelix.
- D. Teach the client methods to fall asleep and stay asleep.
Correct Answer: C
Rationale: A: Constipation is a side effect of abarelix and is important to monitor but is not the priority. B: Breast pain with tenderness is a side effect of abarelix and is important to monitor but is not the priority. C: The nurse's priority should be to observe the client for at least 30 minutes after abarelix (Plenaxis) administration. The risk of a severe allergic reaction increases with each dose and can occur within a short time after administration. D: Sleep disturbances are common side effects of abarelix, and teaching about sleep hygiene is important but not the priority.
The nurse is working with the family whose child is taking atomoxetine for ADHD. Which instructions should the nurse include when teaching the parents? Select all that apply.
- A. Provide stimulation because atomoxetine causes sedation.
- B. Administer atomoxetine immediately after eating a meal.
- C. Administer atomoxetine at least 6 hours before bedtime.
- D. Weigh the child weekly to monitor for unintended weight loss.
- E. Consult with the prescriber before giving cold or allergy medication.
Correct Answer: B,C,D,E
Rationale: Atomoxetine (Strattera) should be taken after meals, at least 6 hours before bedtime, with weekly weight monitoring and caution with OTC medications.
Melissa Smith came to the Emergency Department in the last week before her estimated date of confinement complaining of headaches, blurred vision, and vomiting. Suspecting PIH, the nurse should best respond to Melissa's complaints with which of the following statements?
- A. The physician will probably want to admit you for observation.'
- B. The physician will probably order bed rest at home.'
- C. These are really dangerous signs.'
- D. The physician will probably prescribe some medicine for you.'
Correct Answer: B
Rationale: Pregnancy-induced hypertension (PIH) symptoms like headaches, blurred vision, and vomiting suggest preeclampsia, which is best managed with bed rest at home unless severe, requiring hospitalization.
For a client with suspected appendicitis, the nurse should expect to find abdominal tenderness in which quadrant?
- A. upper right
- B. upper left
- C. lower right
- D. lower left
Correct Answer: C
Rationale: The nurse should expect to find abdominal tenderness in the lower-right quadrant in a client with appendicitis.