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The parent of the 2-year-old with asthma has been given instructions about asthma control and Step Therapy. Which statement, if made by the parent, should indicate to the nurse that the parent has an adequate understanding of the instructions?
- A. If my child has wheezing twice a week or less, I should add the nebulized corticosteroid and make an appointment.
- B. If my child has a respiratory tract infection I should add the nebulized corticosteroid and make an appointment.
- C. If my child has to use the nebulizer less than twice a week, I should add the nebulized corticosteroid and make an appointment.
- D. If my child has nighttime awakenings with wheezing twice a month or more, I should add the nebulized corticosteroid and make an appointment.
Correct Answer: D
Rationale: A: Asthma symptoms (wheezing) occurring 2 or fewer days per week should be treated at Step 1. B: A respiratory tract infection may require the increased use of short-acting beta agonists, but an inhaled corticosteroid should not be added until the child is evaluated by the HCP. C: The use of the nebulizer twice a week or less should be treated at Step 1. D: Nighttime waking with asthma symptoms 1 to 2 times per month indicates the need to proceed to Step 2 therapy, which includes the use of an inhaled corticosteroid.
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The client taking carbamazepine XR for seizure control reports that pieces of the medication are being passed into the stool. Which action by the nurse is most important?
- A. Report this to the health care provider.
- B. Reassure the client that this is normal.
- C. Collect the stool for laboratory analysis.
- D. Document the findings in the medical record.
Correct Answer: B
Rationale: A: It is inappropriate to report an expected finding to the HCP. B: Carbamazepine XR (Tegretol XR) is a sustained-release medication with a coating that is not absorbed but is excreted in feces and may be visible in stool. The nurse should reassure the client that this is normal. C: Collecting the stool for laboratory analysis is not necessary because the coating is not absorbed but excreted in the stool. D: The nurse should document the client teaching but usually would not document the presence of the coating in the client's stool.
The 8-year-old child with gastroenteritis is prescribed to receive 500 mL of lactated Ringer's (LR) solution over the next 10 hours. How many milliliters per hour should the nurse administer?
Correct Answer: 50
Rationale: 500 mL / 10 hr = 50 mL/hr
The new nurse describes the action of TCAs as relieving symptoms of depression by inhibiting neuronal uptake of the neurotransmitters serotonin and norepinephrine. Place an X on the labeled site where the new nurse is stating that inhibition takes place.
- A. Axon of the presynaptic neuron
- B. Rceptor site
- C. Inactivator
- D. Neurotransmitor
- E. Mitochondrion
Correct Answer: B
Rationale: Neuronal uptake of neurotransmitters occurs at the receptor sites on the postsynaptic neuron. [Image-based question; X placed on postsynaptic receptor sites.]
Which statement best describes electrolytes in intracellular and extracellular fluid?
- A. There is a greater concentration of sodium in extracellular fluid and potassium in intracellular fluid
- B. There is an equal concentration of sodium and potassium in extracellular fluid
- C. There is a greater concentration of potassium in extracellular fluid and sodium in intracellular fluid
- D. There is an equal concentration of sodium and potassium between intracellular and extracellular fluid
Correct Answer: A
Rationale: There is a greater concentration of sodium in extracellular fluid and potassium in intracellular fluid, maintaining cellular function and fluid balance.
Methylphenidate hydrochloride is prescribed for the child with ADHD. The nurse should teach the parents to administer the medication in which way?
- A. Whenever the child exhibits inattention behaviors
- B. Whenever the child exhibits hyperactive behaviors
- C. With a snack before bed to calm the child for sleep
- D. During or after meals if the medication decreases appetite
Correct Answer: D
Rationale: A: Methylphenidate is usually given twice daily at or before breakfast and at noon, not whenever inattention behaviors occur. B: Methylphenidate is usually given twice daily at or before breakfast and at noon, not whenever hyperactive behaviors occur. C: The last dose of the medication should be given before 6 p.m. to prevent insomnia. D: A side effect of methylphenidate hydrochloride (Ritalin) is anorexia. It should be given during or immediately after breakfast and lunch to prevent a decreased intake.