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Which antiepileptic medication is associated with gingival hyperplasia?
- A. Gingival hyperplasia (overgrowth of gum tissue) is unique to phenytoin (Dilantin) among antiepileptic medications. About 20% of people taking phenytoin have gingival hyperplasia. This can be minimized with thorough oral care.
- B. Valproic acid (Depakote) does not have a side effect of gingival hyperplasia.
- C. Gingival hyperplasia is not a side effect of carbamazepine (Tegretol).
- D. Gingival hyperplasia is not a side effect of phenobarbital (Luminal).
Correct Answer: A
Rationale: Phenytoin (Dilantin) is uniquely associated with gingival hyperplasia, which can be mitigated with good oral hygiene.
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Which description by the nurse most accurately states the purpose of halo-cervical traction?
- A. It restricts neck movement but enables physical activity.
- B. It allows head movement while immobilizing the spine.
- C. It accelerates healing by facilitating physical therapy.
- D. It promotes faster bone repair within a shorter time span.
Correct Answer: A
Rationale: Halo-cervical traction immobilizes the cervical spine to promote healing while allowing some physical activity (e.g., walking), unlike other options that inaccurately describe its function.
The nurse is preparing to teach the family of an infant with developmental dysplasia of the hip how to apply the Pavlik harness illustrated that has white velcro straps. Place the steps for applying the Pavlik harness in the correct sequence.
- A. Connect the chest halter and leg straps in front.
- B. Position the legs and feet in the stirrups.
- C. Connect the chest halter and leg straps in back.
- D. Position the chest halter at nipple line and fasten with Velcro.
- E. Be sure the hips are flexed and abducted before fastening with Velcro.
Correct Answer: D,B,E,A,C
Rationale: The correct sequence ensures proper positioning and secure application of the Pavlik harness.
The nurse is to administer nafcillin 500 mg intravenously to the client with osteomyelitis. A vial of 1 g of powdered nafcillin is to be reconstituted with 3.4 mL of 0.9% NaCl. How many milliliters should the nurse plan to administer?
- A. 1.7 mL
Correct Answer: A
Rationale: Rationale: 500 mg / 1,000 mg = x / 3.4 mL; x = 1.7 mL. The nurse should prepare 1.7 mL nafcillin (Nallpen).
The occupational health nurse is planning health promotion activities for a group of factory workers. Which activity is an example of primary prevention for clients at risk for low back pain?
- A. Teach back exercises to workers after returning from an injury.
- B. Place signs in the work area about how to perform first aid.
- C. Start a weight-reduction group to meet at lunchtime.
- D. Administer a nonnarcotic analgesic to a client complaining of back pain.
Correct Answer: C
Rationale: Weight reduction reduces spinal stress, a primary prevention strategy for low back pain. Post-injury exercises are secondary, first aid signs are tertiary, and analgesics treat symptoms, not prevent.
The client is scheduled for a computed tomography (CT) scan. Which question is most important for the nurse to ask before the procedure?
- A. On a scale of 1 to 10, how do you rate your pain?'
- B. Do you feel uncomfortable in enclosed spaces?'
- C. Are you allergic to seafood or iodine?'
- D. Have you signed a permit for this procedure?'
Correct Answer: C
Rationale: Iodine/seafood allergies are critical to assess before CT with contrast to prevent anaphylaxis. Claustrophobia, pain, and consent are secondary.