Nokea
Which of the following is true when administering a nasal spray medication?
- A. The client should blow their nose gently before the medication is administered.
- B. The medication should be sprayed in front of the nose.
- C. The medication should be administered as the patient exhales.
- D. The client should lay flat when the medication is administered.
Correct Answer: A
Rationale: The client should blow their nose gently before the medication is administered. This is to clear the nasal passages to allow the medication to be properly administered. When administering the medication, the client should sit upright, insert the applicator into the designated nostril, and spray the medication as the patient inhales.
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The nurse is assessing the 13-year-old who has been taking somatropin recombinant. Which findings should the nurse report to an HCP?
- A. Erythematous palmar rash
- B. Blood pressure of 122/74 mm Hg
- C. Random blood glucose of 158 mg/dL
- D. X-ray report noting epiphyseal closure
Correct Answer: D
Rationale: A: Erythematous palmar rash is not associated with the use of GH. B: BP of 122/74 in a 13-year-old is considered normal. C: Although GH use may be associated with blood glucose changes, a random blood glucose of 158 mg/dL is normal. D: Somatropin (Genotropin) recombinant is an injectable GH indicated for children with a deficiency of the hormone. It cannot be given once the epiphyses have closed. The nurse should notify the HCP.
The 9-year-old with SLE is receiving large doses of prednisolone. Which laboratory finding should the nurse recognize as an untoward effect of the medication?
- A. Total bilirubin of 4 mg/dL
- B. WBC count of 18,000/mm3
- C. Serum sodium of 130 mEq/L
- D. Random glucose of 130 mg/dL
Correct Answer: B
Rationale: A: The liver is not affected by prednisolone use, so an increased total bilirubin of 4 mg/dL is not related to the use of the drug. Normal total bilirubin in a 9-year-old should be less than 2 mg/dL. B: A WBC count of 18,000/mm3 may indicate an infection, an untoward effect of prednisolone (Omnipred). Prednisolone, a corticosteroid used to reduce inflammation, may increase the risk of infection. The normal WBC in a 9-year-old is 4500-11,100/mm3. C: Prednisolone has been associated with the adverse effect of hypokalemia, but not hyponatremia. Normal serum sodium is 135-145 mEq/L. D: Although corticosteroids may have the effect of increasing blood glucose, a random glucose of 130 mg/dL is not abnormal.
When caring for pediatric clients, the nurse should pay special attention to the psychosocial development stages credited to ?
- A. Robert Peck
- B. Erik Erikson
- C. Sigmund Freud
- D. Jean Piaget
Correct Answer: B
Rationale: Erik Erikson is credited with the psychosocial development theory and eight stages. The nurse should take these stages into account when caring for pediatric clients to assess their development. Jean Piaget is responsible for cognitive development. Sigmund Freud is responsible for psychosexual development. Robert Peck is responsible for aging theory.
The client with MS is prescribed baclofen. Which information is most important for the nurse to evaluate when caring for this client?
- A. Serum baclofen levels
- B. Muscle rigidity and pain
- C. Intake and urine output
- D. Daily weight pattern
Correct Answer: B
Rationale: A: There is no serum baclofen level. B: Baclofen (Lioresal) is used primarily to treat spasticity in MS and spinal cord injuries. The nurse should assess for muscle rigidity, movement, and pain to evaluate medication effectiveness. C: Although baclofen can cause urinary urgency, this is not the most important information. D: Baclofen use is not associated with weight.
The severely depressed client tells the nurse, “I don't need these antidepressants; they're too expensive! I'm going to use St. John's wort instead.†Which is the most appropriate response by the nurse?
- A. It would be a safe alternative, especially if you need to watch your finances.
- B. What about taking St. John's wort and an antidepressant for greater effectiveness?
- C. St. John's wort may cost less, but it has not been shown to improve severe depression.
- D. I have some information showing the effective use of St. John's wort. Let's go over it.
Correct Answer: C
Rationale: St. John's wort has not been clinically proven effective for severe depression.