Nokea
Which is a common side effect of short-term corticosteroid therapy?
- A. Fever
- B. Hypertension
- C. Weight loss
- D. Increased appetite
Correct Answer: D
Rationale: Increased appetite is a common side effect of short-term corticosteroid therapy. Corticosteroids can affect the areas of the brain that control appetite, leading to an increase in hunger and potentially weight gain. While weight loss can occur with long-term corticosteroid use, short-term therapy is more likely to cause increased appetite as a side effect. Fever and hypertension are less commonly associated with short-term corticosteroid therapy.
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The nurse is assigned to a client with acquired immunodeficiency syndrome (AIDS). When handling the client's blood and body fluids, the nurse uses standard precautions, which include:
- A. Wearing gloves to empty a bedpan
- B. Wearing gown, gloves, and protective eyewear when obtaining a urine specimen via catheterization
- C. Disposing of needles uncapped
- D. Wearing gloves when applying eyedrops
Correct Answer: A
Rationale: Standard precautions are infection control practices designed to prevent transmission of diseases like AIDS. When handling a client's blood and body fluids, it is important to use standard precautions. Wearing gloves to empty a bedpan is an appropriate practice to prevent direct contact with blood and body fluids. This helps protect the nurse from exposure to infectious agents. Other options like wearing a gown, gloves, and protective eyewear for obtaining a urine specimen via catheterization or disposing of needles uncapped do not align with standard precautions for handling blood and body fluids in a client with AIDS. Similarly, wearing gloves when applying eyedrops is not necessary for preventing transmission of bloodborne pathogens in this context.
Which of the ff must the nurse consider when administering IV fluids to clients with hypertension?
- A. The nurse checks the clients BP every hour
- B. The nurse checks the site and progress of the infusion every hour
- C. The nurse checks the progress of the infusion once a day
- D. The nurse checks the client's pulse rate every hour
Correct Answer: B
Rationale: When administering IV fluids to clients with hypertension, the nurse must closely monitor the site and progress of the infusion every hour to ensure proper hydration and detect any signs of complications such as infiltration or infection. Checking the blood pressure every hour, as in choice A, may not be necessary unless specifically indicated by the healthcare provider. Checking the progress of the infusion once a day, as in choice C, does not provide adequate monitoring for a client with hypertension who may be at higher risk for fluid volume overload. Checking the client's pulse rate every hour, as in choice D, is important but does not directly address the immediate monitoring needs related to the administration of IV fluids.
A client who has been taking prednisone to treat lupus erythematosus has discontinued the medication because of lack of funds to buy the drug. When the nurse becomes aware of the situation, which assessment is most important for the nurse to make first?
- A. breath sounds
- B. blood pressure
- C. capillary refill
- D. butterfly rash
Correct Answer: B
Rationale: The most important assessment for the nurse to make first in this situation is the client's blood pressure. Abrupt discontinuation of prednisone, especially in a client with lupus erythematosus, can lead to adrenal insufficiency or an Addisonian crisis. Addisonian crisis can present with symptoms such as severe hypotension, fatigue, weakness, and even shock. Therefore, monitoring the client's blood pressure is crucial to assess for signs of adrenal insufficiency and to intervene promptly if needed. Once blood pressure is assessed, the nurse can then proceed to assess other parameters such as breath sounds, capillary refill, and the presence of a butterfly rash.
Which behaviors by the nurse indicate a therapeutic relationship with children and families? (Select all that apply.)
- A. Spending off-duty time with children and families
- B. Asking questions if families are not participating in the care
- C. Clarifying information for families
- D. Buying toys for a hospitalized child
Correct Answer: B
Rationale: Asking questions if families are not participating in the care is a behavior that indicates a therapeutic relationship with children and families. It shows the nurse's concern and interest in understanding the family's perspectives and addressing any barriers to participation.
A client in the final stages of terminal cancer tells the nurse: "I wish I could be just be allowed to die. I'm tired of fighting this illness. I have lived life a good life. I only continue my chemotherapy and radiation treatment because my family wants me to." What is the best nurse's best response?
- A. "Would you like to talk to a psychologist about your thoughts and feelings?"
- B. "Would you like to talk to your minister about the significance of death?"
- C. "Would you like to meet with your family and your physician about this matter?"
- D. "I know you are tired of fighting this illness, but death will come in due time."
Correct Answer: A
Rationale: The best response for the nurse to provide in this situation is to offer the client the option to talk to a psychologist about their thoughts and feelings. This demonstrates the nurse's understanding and compassion towards the client's emotional struggles and the complexity of their situation. By suggesting a professional to talk to, the nurse can provide the client with the appropriate support and guidance to help them navigate their feelings of wanting to be allowed to die. It also allows the client to voice their concerns and emotions with a trained professional who can offer them coping strategies and support tailored to their individual needs.