Nokea
Which discharge teaching instructions should the nurse reinforce to the parents of a 2-year-old with group A streptococcal pharyngitis? Select all that apply.
- A. Complete all the antibiotics even if your child is feeling better
- B. Cool liquids and soft diet are recommended
- C. Keep your child home from daycare for at least a week
- D. Replace your child’s toothbrush 24 hours after starting antibiotics
- E. Throat lozenges may soothe your child’s sore throat
Correct Answer: A,B,D
Rationale: Completing antibiotics prevents resistance, cool liquids/soft foods ease swallowing, and replacing the toothbrush prevents reinfection. A week-long daycare exclusion is excessive (24-48 hours post-antibiotics is sufficient), and lozenges are unsafe for a 2-year-old due to choking risk.
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Which of these clients is at greatest risk for the complications associated with osteoporosis?
- A. A 22-year-old woman with anorexia nervosa who is not having menstrual periods
- B. A 65-year-old Asian-American man who is sedentary, has a low calcium intake, and takes corticosteroids for chronic obstructive pulmonary disease
- C. A 70-year-old postmenopausal woman who has limited mobility due to rheumatoid arthritis, for which she takes corticosteroids, and who drinks a bottle of wine by herself each evening
- D. A 70-year-old woman who takes estrogen therapy, was very athletic in her youth playing tennis and golf, and takes anticonvulsant therapy as a result of a head injury suffered in an auto accident three years ago
Correct Answer: C
Rationale: The 70-year-old postmenopausal woman has multiple risk factors: age, immobility, corticosteroid use, and alcohol consumption, maximizing osteoporosis complication risk.
Which information should be included in the nurse's shift report?
- A. The client's sodium level is 147 mEq/L
- B. The client's potassium level is 4 mEq/liter
- C. The client's urine output was 1500 cc in 5 hours
- D. The client is to receive another dose of Lasix at 10 PM
Correct Answer: C
Rationale: Although all of these may be correct information to include in report, the essential piece would be the urine output, as it indicates the client's fluid status and response to treatment.
The nurse is talking with a client who has schizophrenia. The client states, 'I had a pet rabbit when I was growing up. Carrots are probably my favorite vegetable. Do you know that oranges grow on trees?' The nurse should recognize that the client is demonstrating
- A. associative looseness
- B. concrete thinking
- C. tangentiality
- D. neologisms
Correct Answer: C
Rationale: Tangentiality involves shifting topics without clear connections, as seen in the client’s unrelated statements about rabbits, carrots, and oranges. Associative looseness is more disorganized, concrete thinking lacks abstract thought, and neologisms involve invented words.
A client is admitted with suspected pheochromocytoma. The physiological alteration associated with pheochromocytoma is:
- A. An extreme elevation in blood pressure
- B. Petechial rash across the chest and axilla
- C. White flecks in the iris
- D. Yellow creases at the nasolabial folds
Correct Answer: A
Rationale: Pheochromocytoma causes catecholamine release, leading to extreme hypertension . Rash , iris flecks , and nasolabial creases are not associated.
The nurse has attended a staff education program about ethical practices in nursing. Which of the following statements by the nurse would indicate a correct understanding of the program? Select all that apply.
- A. Accountability is notifying the health care provider after making a medication error.
- B. Autonomy is informing the client of the care decisions the family has made for the client.
- C. Confidentiality is respecting a client's request to keep suicidal ideation a secret from other members of the health care team.
- D. Fidelity is returning to the client's room with pain medication at the time that was promised to the client.
- E. Nonmaleficence is reporting suspected elder abuse of a client with Alzheimer disease.
Correct Answer: A,D,E
Rationale: Accountability involves taking responsibility for errors (A). Fidelity is keeping promises, such as timely medication delivery (D). Nonmaleficence includes preventing harm by reporting abuse (E). Autonomy respects the client's decision-making, not family decisions (B), and confidentiality does not extend to withholding suicidal ideation, which requires intervention (C).