Nokea
Which of the following demonstrates that the client needs further instruction after being taught about ciprofloxacin (Cipro)?
- A. I must drink 1,000 to 1,500mL of water a day
- B. I shouldn't take an antacid before taking the Cipro
- C. I should let the doctor know if I start vomiting from the Cipro
- D. I may get light-headed from the Cipro
Correct Answer: A
Rationale: Adequate hydration is important with ciprofloxacin, but 1,000–1,500 mL may be insufficient for adults, who typically need 2,000–3,000 mL daily to prevent crystalluria. Other statements are correct.
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A client with a history of type 2 diabetes mellitus is prescribed pioglitazone (Actos). The nurse should monitor the client for which of the following side effects?
- A. Hypoglycemia.
- B. Weight gain.
- C. Hypertension.
- D. Dry skin.
Correct Answer: B
Rationale: Pioglitazone can cause weight gain due to fluid retention, requiring monitoring in diabetic clients.
Which interventions should the nurse use to assist the client with grandiose delusions? Select all that apply.
- A. Accepting the client while not arguing with the delusion.
- B. Focusing on the feelings or meaning of the delusion.
- C. Focusing on events and topics based in reality.
- D. Confronting the client's beliefs.
- E. Interacting with the client only when he is based in reality.
Correct Answer: A,B,C
Rationale: To manage grandiose delusions, the nurse should accept the client without reinforcing the delusion, focus on the underlying feelings, and redirect to reality-based topics. Confronting beliefs or limiting interaction to reality-based moments can escalate agitation or alienate the client.
When creating a program to decrease the primary cause of disability and death in children, which of the following is most effective for the community health nurse to do?
- A. Encourage state legislators to draft legislation to promote prenatal care.
- B. Recommend that the health department make immunizations available at no cost to all children.
- C. Teach health and safety practices to children and their parents.
- D. Have a nurse practitioner hired for each of the schools in the community.
Correct Answer: B
Rationale: Free immunizations address the leading cause of preventable childhood disability and death by ensuring widespread protection against infectious diseases.
The nurse is planning care for a client with a chest tube attached to a chest drainage system. Which actions should the nurse include as part of routine chest tube care? Select all that apply.
- A. Encourage the client to cough and deep breathe.
- B. Add water to the suction chamber as it evaporates.
- C. Keep the collection chamber below the client's waist.
- D. Clamp the chest tube when the client gets out of bed.
- E. Tape the connection between the chest tube and the drainage system.
Correct Answer: A,B,C,E
Rationale: The client is encouraged to cough and deep breathe to assist in lung expansion. Water is added to the suction control chamber as needed to maintain the full suction level prescribed. The nurse keeps the drainage collection system below the level of the client's waist to prevent fluid or air from reentering the pleural space. Connections between the chest tube and system are taped to prevent accidental disconnection. To avoid causing tension pneumothorax, the nurse avoids clamping the chest tube for any reason unless specifically prescribed. In most instances, clamping of the chest tube is contraindicated by agency policy.
A 17-year-old client has been admitted to the hospital for a biopsy to confirm the diagnosis of bone cancer. The nurse should assess the client for which conditions? Select all that apply.
- A. Cough.
- B. Dyspnea.
- C. Pain.
- D. Swelling.
- E. Fever.
- F. Anorexia.
- G. Decreased range of motion.
Correct Answer: C,D,E,F,G
Rationale: Bone cancer may cause pain, swelling, fever, anorexia, and decreased range of motion due to tumor effects on bone and surrounding tissues. Cough and dyspnea are less common unless metastasis occurs.