Nokea
What is pica?
- A. dependency on alcohol
- B. increased iron in the diet
- C. the sickle cell trait
- D. eating ice
Correct Answer: D
Rationale: Pica represents the ingestion of nonfood substances that leads to a clinical iron deficiency and might actually be the first sign of a problem. Clients eat a wide range of nonfood items, including ice, clay, dirt, and paste.
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The nurse is caring for a female client who has recently been diagnosed with cancer and will soon begin chemotherapy. Which of these statements would require additional follow-up and education?
- A. I will be most susceptible to an infection between 7 and 12 days after chemotherapy.
- B. I should try to get my annual teeth cleaning in before beginning chemotherapy.
- C. I should wait until all my hair falls out to purchase a wig.
- D. I should try to drink 8-10 glasses of water a day.
Correct Answer: C
Rationale: This client is at risk for altered body image secondary to the hair loss from chemotherapy. A wig can be helpful in coping with this, and the client should shop for a wig before his or her hair falls out so that he or she can better match his or her color and style. The remaining statements are accurate.
The nurse evaluates that pancrelipase is having the optimal intended benefit for the client with CF. Which assessment finding prompted the nurse's conclusion?
- A. The client lost 4 pounds in 1 month.
- B. The client no longer has heartburn.
- C. The client has increased steatorrhea.
- D. The client has improved nutritional status.
Correct Answer: D
Rationale: A: Weight gain, not weight loss, is an intended effect. B: Pancrelipase is not used to treat abdominal heartburn. C: Pancrelipase reduces the amount of fatty stools (steatorrhea). D: Pancrelipase (Pancreaze) is a pancreatic enzyme used in clients with deficient exocrine pancreatic secretions, CF, chronic pancreatitis, or steatorrhea from malabsorption syndrome. Because it aids digestion, the nutritional status should be improved.
The client taking paroxetine telephones the mental health clinic nurse and states, “Since I started taking St. John's wort, I have had a high fever and muscle stiffness, and I am sweating a lot.†Which statement is most appropriate?
- A. You may have the flu; call your primary provider to make an appointment.
- B. Take ibuprofen, drink fluids, and rest; call tomorrow if the symptoms worsen.
- C. Could you have doubled up on your medication, taking more than prescribed?
- D. You should be taken to the emergency department right away to be evaluated.
Correct Answer: D
Rationale: Fever, muscle stiffness (rigidity), and diaphoresis are symptoms of serotonin syndrome, a potentially fatal condition that may occur with concurrent use of St. John's wort and paroxetine (Paxil). The client should be taken to the ED.
The nurse completes teaching insulin administration to the parent of the toddler newly diagnosed with type 1 DM. The nurse concludes that the teaching was successful when the parent makes which statement?
- A. NPH insulin is only given at night immediately before the bedtime snack.
- B. I should use only the buttocks for the insulin injections until the child is older.
- C. Insulin lispro acts within 15 minutes and peaks 30 to 90 minutes after injection.
- D. Insulin detemir can be added to the insulin lispro pen to reduce the number of injections.
Correct Answer: C
Rationale: A: NPH (Humulin N) insulin can be given in the morning, but there is better glucose control if given at night. NPH peaks in 4 to 14 hours, so there is no need to make sure food is given immediately after administration. B: Insulin injections should always be rotated to prevent subcutaneous tissue damage from giving the injections in the same location. C: Lispro (Humalog) is rapid-acting insulin that peaks in 30 to 90 minutes and may last as long as 5 hours in the blood. This statement is correct, indicating teaching is effective. D: Detemir (Levemir) is long-acting and lispro (Humalog) is rapid-acting insulin. An insulin pen uses prefilled, multiple-use insulin cartridges; adding other types of insulins should not be attempted.
The LPN is performing an assessment on a 4-day-old 8-pound, 6-ounce newborn with a head circumference of 33 cm. Given this information, what would the nurse expect the child's chest circumference to be?
- A. about 31 cm
- B. about 36 cm
- C. about 29 cm
- D. about 33 cm
Correct Answer: A
Rationale: In newborns, the head circumference should be 2 cm to 3 cm larger than the chest circumference. Note: Due to molding that occurs during the birth process, the head and chest measurement may be nearly equal during the first 48 hours after birth.