Nokea
Which information should be given to a client taking Dilantin (phenytoin)?
- A. Taking the medication with meals will increase its effectiveness
- B. The medication can cause sleep disturbances
- C. More frequent dental appointments will be needed for special gum care
- D. The medication decreases the effects of oral contraceptives
Correct Answer: C
Rationale: Phenytoin can cause gingival hyperplasia, necessitating more frequent dental visits for gum care.
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The nurse is caring for a client who is postoperative day 1 after a laparoscopic cholecystectomy. Which of the following findings would be of GREATest concern to the nurse?
- A. Temperature of 100.8°F (38.2°C).
- B. Pain at the incision site.
- C. Right shoulder pain.
- D. Urine output of 40 mL/hour.
Correct Answer: A
Rationale: A temperature of 100.8°F suggests infection, a serious complication post-cholecystectomy requiring immediate evaluation. Options B, C, and D are expected: incision pain is normal, shoulder pain is from referred diaphragmatic irritation, and urine output 40 mL/hour is adequate.
The nurse discovers that a hospitalized client is not breathing and has no pulse. After calling for help, what should the nurse do next?
- A. Give the client two breaths
- B. Administer five chest compressions
- C. Go get the emergency cart
- D. Defibrillate the client
Correct Answer: A
Rationale: Per CPR guidelines, after calling for help, provide two rescue breaths if trained, followed by compressions. Fetching the cart or defibrillating delays resuscitation.
A patient has a Levin tube connected to intermittent low suction. At 7 AM, the nurse charts that there is 235 cc of greenish drainage in the suction container. At 3 PM, the nurse notes that there is 445 cc of greenish drainage in the suction container. Twice during the shift, the nurse irrigates the Levin tube with 30 cc of normal saline, as ordered by the physician. What is the actual amount of drainage from the nasogastric tube for the 7 to 3 shift?
- A. 150 cc.
- B. 210 cc.
- C. 295 cc.
- D. 385 cc.
Correct Answer: A
Rationale: 445-235=210-60=150
A toddler with otitis media has just completed antibiotic therapy. A recheck appointment should be made to:
- A. Determine whether the ear infection has affected her hearing.
- B. Determine whether she needs a tympanoplasty.
- C. Document that the infection has completely cleared.
- D. Obtain a new prescription in case the infection recurs.
Correct Answer: C
Rationale: A recheck confirms the otitis media has cleared, preventing complications. Hearing tests or tympanoplasty are not routine, and new prescriptions are unnecessary unless recurrence occurs.
A client with considerable pain asks, 'What is your opinion regarding acupuncture as a drug-free method for alleviating pain?' The nurse responds, 'I'd forget about it as those weird non-Western treatments can be scary.' The nurse's response is an example of
- A. prejudice
- B. discrimination
- C. ethnocentrism
- D. cultural insensitivity
Correct Answer: C
Rationale: Ethnocentrism, the universal tendency of human beings to think that their ways of thinking, acting, and believing are the only right, proper, and natural ways, can be a major barrier to providing culturally conscious care.