Nokea
The provider has ordered daily high doses of aspirin for a client with rheumatoid arthritis. The nurse instructs the client to discontinue the medication and contact the provider if which of the following symptoms occur?
- A. Infection of the gums
- B. Diarrhea for more than one day
- C. Numbness in the lower extremities
- D. Ringing in the ears
Correct Answer: D
Rationale: Ringing in the ears. Aspirin stimulates the central nervous system which may result in ringing in the ears.
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The client is diagnosed with tuberculosis and prescribed rifampin and isoniazid (INH), both antituberculosis medications. Which instruction is most important for the public health nurse to discuss with the client?
- A. The client will have to take the medications for nine (9) to 12 months.
- B. The client will have to stay in isolation as long as he or she is taking medications.
- C. Explain the client cannot eat any type of pork products while taking the medication.
- D. The urine may turn turquoise in color, but this is an expected occurrence and harmless.
Correct Answer: A
Rationale: TB treatment requires 9–12 months for cure, ensuring adherence is critical to prevent resistance, a public health priority. Isolation, pork, or urine color are incorrect or less urgent.
The client diagnosed with methicillin-resistant Staphylococcus aureus (MRSA) is receiving the aminoglycoside antibiotic vancomycin. Peak and trough levels are ordered for the dose the nurse is administering. Which priority intervention should the nurse implement?
- A. Ask the client if he has had any diarrhea.
- B. Monitor the aminoglycoside peak level.
- C. Determine if the trough level has been drawn.
- D. Check the client's culture and sensitivity report.
Correct Answer: C
Rationale: Trough levels must be drawn before the next vancomycin dose to ensure therapeutic levels and avoid toxicity; this is the priority. Diarrhea, peak levels, or culture reports are secondary.
A 66 year-old client is admitted for mitral valve replacement surgery. The client has a history of mitral valve regurgitation and mitral stenosis since her teenage years. During the admission assessment, the nurse should ask the client if as a child she had
- A. measles
- B. rheumatic fever
- C. hay fever
- D. encephalitis
Correct Answer: B
Rationale: rheumatic fever. Clients that present with mitral stenosis often have a history of rheumatic fever or bacterial endocarditis.
The nurse is to administer an IM injection to a 6-month-old child. What is the most appropriate site to use?
- A. Vastus lateralis
- B. Dorsal gluteal
- C. Ventral gluteal
- D. Iliac crest
Correct Answer: A
Rationale: Infants and small children do not have enough muscle in the gluteal area to use that site. The vastus lateralis is the appropriate site. The iliac crest is a site used for SC injections, not IM.
A client has bilateral knee pain from osteoarthritis. In addition to taking the prescribed non-steroidal anti-inflammatory drug (NSAID), the nurse should instruct the client to
- A. start a regular exercise program
- B. rest the knees as much as possible to decrease inflammation
- C. avoid foods high in citric acid
- D. keep the legs elevated when sitting
Correct Answer: A
Rationale: start a regular exercise program. A regular exercise program is beneficial in treating osteoarthritis. It can restore self-esteem and improve physical functioning.