Nokea
Which of the following symptoms is most characteristic of a client with cancer of the lungs?
- A. Exertional dyspnea
- B. Persistent changing cough
- C. Air hunger; dyspnea
- D. Cough with night sweats
Correct Answer: B
Rationale: A persistent, changing cough is the most characteristic symptom of lung cancer, distinguishing it from symptoms associated with COPD, asthma, or tuberculosis.
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In teaching bleeding precautions to a client with leukemia, the PN should include which of the following instructions?
- A. Use a soft toothbrush
- B. Use dental floss daily
- C. Hold pressure on any scrapes for 1-2 minutes
- D. Use a triple-edged razor
Correct Answer: A
Rationale: A soft toothbrush minimizes gum bleeding in leukemia clients with low platelets. Dental floss and razors increase bleeding risk, and pressure should be held for 5-10 minutes.
The nurse is caring for the client taking atorvastatin. The nurse should assess for which adverse effects?
- A. Constipation and hemorrhoids
- B. Muscle pain and weakness
- C. Fatigue and dysrhythmias
- D. Flushing and postural hypotension
Correct Answer: B
Rationale: A: Bile acid sequestrants act by inhibiting bile acids from absorption by the small intestine. This results in fewer bile acids in the small intestine, which may lead to constipation and hemorrhoids. B: Atorvastatin (Lipitor) is a 3-hydroxy-3-methylglutaryl coenzyme A (HMG-CoA) reductase inhibitor (statin) used to lower lipid levels. Statins can cause muscle tissue injury manifested by muscle ache or weakness. Muscle injury can progress to myositis (muscle inflammation) or rhabdomyolysis (muscle disintegration). C: Diarrhea, not constipation, has been found to be a side effect of statin medications. D: Side effects of niacin, a lipid-lowering agent, include flushing, dysrhythmias, and postural hypotension.
The client experiencing an acute attack of gouty arthritis is prescribed colchicine 1 mg IV now and then 0.5 mg q6h. Colchicine 0.5 mg/mL in a 2-mL ampule is available. How many milliliters should the nurse administer for the initial dose?
Correct Answer: 2
Rationale: Use a proportion formula; multiply the extremes (outside values) and then the means (inside values), and solve for X. 0.5 mg: 1 mL :: 1 mg: X mL; 0.5X = 1; 1 / 0.5 = 2; X = 2 mL. Colchicine (Colcrys) interferes with the function of WBCs in initiating and perpetuating the inflammatory response to monosodium urate crystals.
The parent of the 2-year-old with asthma has been given instructions about asthma control and Step Therapy. Which statement, if made by the parent, should indicate to the nurse that the parent has an adequate understanding of the instructions?
- A. If my child has wheezing twice a week or less, I should add the nebulized corticosteroid and make an appointment.
- B. If my child has a respiratory tract infection I should add the nebulized corticosteroid and make an appointment.
- C. If my child has to use the nebulizer less than twice a week, I should add the nebulized corticosteroid and make an appointment.
- D. If my child has nighttime awakenings with wheezing twice a month or more, I should add the nebulized corticosteroid and make an appointment.
Correct Answer: D
Rationale: A: Asthma symptoms (wheezing) occurring 2 or fewer days per week should be treated at Step 1. B: A respiratory tract infection may require the increased use of short-acting beta agonists, but an inhaled corticosteroid should not be added until the child is evaluated by the HCP. C: The use of the nebulizer twice a week or less should be treated at Step 1. D: Nighttime waking with asthma symptoms 1 to 2 times per month indicates the need to proceed to Step 2 therapy, which includes the use of an inhaled corticosteroid.
The nurse is receiving a report from an ER nurse about a client. Which of the following statements requires additional follow-up?
- A. The client said they have been taking aspirin, but I'm not sure for how long or how much.
- B. The client frequently takes antacids, but they have not taken any in the last three days.
- C. The client stopped taking ibuprofen after developing gastric ulcers.
- D. The client takes Antabuse and has stopped using mouthwash.
Correct Answer: A
Rationale: Aspirin can have an impact on the patient's bleeding risk, so the amount and frequency is important to know. Antacids can change the gastric pH and impact medication absorption, so the nurse should note when they are last taken. Ibuprofen can cause or exacerbate gastric ulcers. Clients who take Antabuse should avoid alcohol in all forms, including avoiding over-the-counter cough medication and mouthwash.