Nokea
Which of the following should not be included in the teaching for clients who take oral iron preparations?
- A. Mix the liquid iron preparation with antacids to reduce GI distress
- B. Take the iron with meals if GI distress occurs
- C. Liquid forms should be taken with a straw to avoid discoloration of tooth enamel
- D. Oral forms should be taken with juice, not milk
Correct Answer: A
Rationale: Iron should not be mixed with antacids, as antacids can reduce iron absorption. The other options are appropriate: taking with meals can reduce GI distress, using a straw prevents tooth discoloration, and juice enhances absorption while milk can inhibit it.
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The client has been receiving clonidine 0.1 mg via transdermal patch once every 7 days. The NA removes the patch with morning cares. Eight hours later, the nurse discovers that the clonidine patch is no longer present. Which assessment finding should be most concerning to the nurse?
- A. Skin tear is noted on the client's upper chest.
- B. Client reports having an excruciating headache.
- C. Blood pressure is noted to be 182/100 mm Hg.
- D. The ECG monitor shows a heart rate of 120 bpm.
Correct Answer: C
Rationale: A: Although a skin tear is concerning and may have occurred during removal, it is not the most concerning. B: Headache can occur from the abrupt removal of clonidine but is not the most concerning. C: Clonidine (Catapres) is an antihypertensive medication. Rebound hypertension occurs from abrupt withdrawal. Immediate intervention is required to lower the BP. D: Tachycardia is an adverse effect of clonidine.
The parent of the child brought to the ED states to the nurse, “My child is sweaty and shaky; I think some of my medication is gone.†The parent hands the nurse the medication bottle illustrated. Which action should the nurse take first?
- A. Start an infusion of D5W at 40 mL/hr.
- B. Give glucagon 1 mg subcutaneously.
- C. Check the child's blood glucose level.
- D. Determine how many tablets were taken.
Correct Answer: C
Rationale: A: Initiating an IV access for glucose administration is more time-consuming than giving glucose by the oral route or glucagon (GlucaGen) subcutaneously to a child who is still responsive. B: An oral form of glucose should be administered if the child is responsive and glucagon given only if the child is unresponsive or too uncooperative or upset to take oral glucose. Glucagon stimulates the release of liver glycogen and releases glucose into the circulation. C: The child may have ingested the glipizide (Glucotrol XL), a sustained-released hypoglycemic agent. The child's blood glucose level should be checked first to determine the appropriate treatment. D: Determining the number of tablets taken may delay the child's treatment.
The nurse is preparing an educational program on immunizations for parents of children 11 to 12 years of age. To ensure the information presented is accurate for this age group, which immunizations should the nurse plan to address?
- A. Haemophilus influenza, varicella, and human papillomavirus (HPV)
- B. Mumps, measles, and rubella (MMR); pneumococcal (PPSV); and hepatitis A
- C. Diphtheria-tetanus-pertussis (DTaP), meningococcal, and haemophilus influenza
- D. Mumps, measles, and rubella (MMR); diphtheria-tetanus-pertussis (DTaP); and hepatitis B
Correct Answer: C
Rationale: A: Varicella vaccines are administered at 12 to 15 months, with the second dose at 4 to 6 years. B: The first dose of hepatitis A vaccine is administered before 1 year of age, with the second dose 6 months after the first dose. C: The recommended immunization schedule for children 11 to 12 years old includes a DTaP booster and meningococcal and haemophilus influenza vaccines. Others include HPV, PPSV, and hepatitis A series. D: MMR vaccines are administered at 12 to 15 months, with the second dose at 4 to 6 years. A hepatitis B vaccine is administered to all newborns prior to hospital discharge, with the second dose at 1 to 2 months and the third dose at 6 to 18 months.
The client is receiving multiple medications for treatment of PD. Which signs and symptoms should the nurse recognize as adverse effects of carbidopa-levodopa?
- A. Dystonia and akinesia
- B. Bradykinesia and agitation
- C. Muscle rigidity and cardiac dysrhythmias
- D. Orthostatic hypotension and dry mouth
Correct Answer: D
Rationale: A: Although dystonia is an adverse effect of carbidopa-levodopa, akinesia is a symptom associated with PD. B: Bradykinesia is a symptom associated with PD; agitation is an adverse effect of carbidopa-levodopa. C: Muscle rigidity is a symptom associated with PD; cardiac dysrhythmia is an adverse effect of carbidopa-levodopa. D: Orthostatic hypotension and dry mouth are common adverse effects of carbidopa-levodopa (Sinemet). These can be minimized by slow position changes and sucking on sugarless candy or chewing gum.
The LPN is taking care of a client who is on Phenelzine (Nardil) for depression. Which meal would the nurse encourage the client to avoid?
- A. steak and potatoes
- B. prosciutto and cheese plate
- C. orange juice and toast
- D. carbonated water, shrimp and rice
Correct Answer: B
Rationale: Phenelzine (Nardil) is a type of MAOI (Monoamine Oxidase Inhibitor). Clients on these drugs should avoid foods and beverages with large amounts of tyramine, as they may cause dangerous elevations in blood pressure. Common foods high in tyramine include aged meats and cheeses, beer, sauerkraut, and soy sauce.