Nokea
Which medication should the nurse administer first during a prolonged seizure?
- A. Phenytoin (Dilantin) IV
- B. Lorazepam (Ativan) IV
- C. Levetiracetam (Keppra) oral
- D. Carbamazepine (Tegretol) oral
Correct Answer: B
Rationale: Lorazepam IV is the first-line treatment for status epilepticus to rapidly stop seizure activity.
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The public health nurse is discussing St. Louis encephalitis with a group in the community. Which instruction should the nurse provide to help prevent an outbreak?
- A. Yearly vaccinations for the disease.
- B. Advise that the city should spray for mosquitoes.
- C. The use of gloves when gardening.
- D. Not going out at night.
Correct Answer: B
Rationale: St. Louis encephalitis is mosquito-borne. Mosquito spraying (B) reduces vector populations. No vaccine exists (A), gloves (C) are irrelevant, and night avoidance (D) is less effective.
Which information should be shared with the client diagnosed with stage I Alzheimer's disease who is prescribed donepezil (Aricept), a cholinesterase inhibitor?
- A. The client must continue taking this medication forever to maintain function.
- B. The drug may delay the progression of the disease, but it does not cure it.
- C. A serum drug level must be obtained monthly to evaluate for toxicity.
- D. If the client develops any muscle aches, the HCP should be notified.
Correct Answer: B
Rationale: Donepezil delays Alzheimer’s progression but does not cure it (B). Lifelong use (A) is not mandatory, serum levels (C) are not routine, and muscle aches (D) are not a primary concern.
When planning care for this client, which equipment is most important for the nurse to keep at the bedside?
- A. A cardiac defibrillator in case of cardiac arrest
- B. A suction machine in case of compromised swallowing
- C. A cooling blanket in case of hyperthermia
- D. An IV infusion pump for fluid administration
Correct Answer: B
Rationale: A suction machine is essential to clear secretions in myasthenia gravis clients with compromised swallowing, preventing aspiration.
The nurse is assessing the client diagnosed with bacterial meningitis. Which clinical manifestations would support the diagnosis of bacterial meningitis?
- A. Positive Babinski’s sign and peripheral paresthesia.
- B. Negative Chvostek’s sign and facial tingling.
- C. Positive Kernig’s sign and nuchal rigidity.
- D. Negative Trousseau’s sign and nystagmus.
Correct Answer: C
Rationale: Kernig’s sign (pain with leg extension) and nuchal rigidity (C) are hallmark signs of bacterial meningitis due to meningeal irritation. Other options include unrelated or less specific findings.
The client diagnosed with delirium tremens when trying to quit drinking cold turkey is admitted to the medical unit. Which medications would the nurse anticipate administering?
- A. Thiamine (vitamin B6) and librium, a benzodiazepine.
- B. Dilantin, an anticonvulsant, and Feosol, an iron preparation.
- C. Methadone, a synthetic narcotic, and Depakote, a mood stabilizer.
- D. Mannitol, an osmotic diuretic, and Ritalin, a stimulant.
Correct Answer: A
Rationale: Delirium tremens requires thiamine (vitamin B1, not B6) to prevent Wernicke’s encephalopathy and benzodiazepines like Librium (A) to manage withdrawal symptoms. Other options are unrelated to delirium tremens management.