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Which of the following statements by a client with a seizure disorder who is taking topiramate (Topamax) indicates that the client has understood the nurse's instruction?
- A. I will take the medicine before going to bed.
- B. I will drink 8 to 10 ten-ounce glasses of water a day.
- C. I will eat plenty of fresh fruits.
- D. I must take the medicine with a meal or snack.
Correct Answer: B
Rationale: Topiramate increases the risk of kidney stones, so adequate hydration (8-10 glasses of water daily) is essential to prevent this complication.
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The nurse is caring for a 7-year-old child with constipation. The child's mother asks the nurse what she can do to help prevent another episode. What information would the nurse include in her response?
- A. Give enemas until the child runs clear.
- B. Give laxatives daily on a regular basis.
- C. Provide lots of milk and sugary foods to promote defecation.
- D. Have the child sit on the toilet for 5 to 10 minutes about 20 to 30 minutes after meals to encourage defecation.
Correct Answer: D
Rationale: Encouraging regular toilet habits after meals promotes bowel regularity without relying on invasive or inappropriate measures like enemas or excessive milk.
The toddler is admitted with a cardiac anomaly. The nurse is aware that the infant with a ventricular septal defect will:
- A. Tire easily
- B. Grow normally
- C. Need more calories
- D. Be more susceptible to viral infections
Correct Answer: A
Rationale: A ventricular septal defect causes increased pulmonary blood flow, leading to easy tiring due to cardiac workload.
Which type of endotracheal tube is recommended by the Centers for Disease Control (CDC) for reducing the risk of ventilator-associated pneumonia?
- A. Uncuffed
- B. CASS
- C. Fenestrated
- D. Nasotracheal
Correct Answer: B
Rationale: CASS (continuous aspiration of subglottic secretions) tubes reduce ventilator-associated pneumonia by removing secretions.
A child with cystic fibrosis is being treated with inhalation therapy with Pulmozyme (dornase alfa). A side effect of the medication is:
- A. Weight gain
- B. Hair loss
- C. Sore throat
- D. Brittle nails
Correct Answer: C
Rationale: Pulmozyme, used to thin mucus in cystic fibrosis, can cause sore throat as a side effect due to irritation from inhalation.
The nurse is caring for a client admitted with suspected myasthenia gravis. Which finding is usually associated with a diagnosis of myasthenia gravis?
- A. Visual disturbances, including diplopia
- B. Ascending paralysis and loss of motor function
- C. Cogwheel rigidity and loss of coordination
- D. Progressive weakness that is worse at the day's end
Correct Answer: D
Rationale: Myasthenia gravis is characterized by muscle weakness that worsens with activity and improves with rest, typically more pronounced at the end of the day.