Which statement indicates the female client with systemic lupus erythematosus (SLE) understands the discharge instructions?
- A. I should wear sunscreen with at least a 5 SPF.
- B. I am not going to any activities with large crowds.
- C. I should not get pregnant because I have SLE.
- D. I must avoid using hypoallergenic products.
Correct Answer: C
Rationale: Avoiding pregnancy prevents SLE complications, indicating understanding. SPF 5 is inadequate, crowd avoidance is not standard, and hypoallergenic products are safe.
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The client diagnosed with an acute exacerbation of SLE is being discharged with a prescription for an oral steroid which will be discontinued gradually. Which statement is the scientific rationale for this type of medication dosing?
- A. Tapering the medication prevents the client from having withdrawal symptoms.
- B. So the thyroid gland starts working, because this medication stops it from working.
- C. Tapering the dose allows the adrenal glands to begin to produce cortisol again.
- D. This is the health-care provider's personal choice in prescribing the medication.
Correct Answer: C
Rationale: Tapering steroids allows adrenal glands to resume cortisol production, preventing adrenal insufficiency. Withdrawal symptoms are secondary, thyroid is unaffected, and it’s not provider preference.
The home health nurse is caring for the client newly diagnosed with multiple sclerosis. Which client issue is of most importance?
- A. The client refuses to have a gastrostomy feeding.
- B. The client wants to discuss if she should tell her fiancé.
- C. The client tells the nurse life is not worth living anymore.
- D. The client needs the flu and pneumonia vaccines.
Correct Answer: C
Rationale: Suicidal ideation indicates a mental health crisis, requiring immediate intervention. Gastrostomy refusal, disclosure to fiancé, and vaccines are less urgent.
The client diagnosed with a bee sting allergy is being discharged from the emergency department. Which priority discharge instruction should be taught to the client?
- A. Demonstrate how to use an EpiPen, an adrenergic agonist.
- B. Teach the client to never go outdoors in the spring and summer.
- C. Have the client buy diphenhydramine over the counter to use when stung.
- D. Discuss wearing a Medic Alert bracelet when going outside.
Correct Answer: A
Rationale: EpiPen use is critical for managing anaphylaxis in bee sting allergies. Avoiding outdoors is impractical, diphenhydramine is secondary, and bracelets are supportive.
Which interventions should the nurse discuss with the female client who is positive for human immunodeficiency virus (HIV)? Select all that apply.
- A. Recommend the client not to engage in unprotected sexual activity.
- B. Instruct the client not to inform past sexual partners of HIV status.
- C. Tell the client to not donate blood, organs, or tissues.
- D. Suggest the client not get pregnant.
- E. Explain the client does not have to tell health-care personnel of HIV status.
Correct Answer: A,C,D
Rationale: Unprotected sex, blood/organ donation, and pregnancy risk HIV transmission or complications. Partner notification and informing healthcare personnel are recommended.
The 20-year-old female client diagnosed with advanced unremitting RA is being admitted to receive a regimen of immunosuppressive medications. Which question should the nurse ask during the admission process regarding the medications?
- A. Are you sexually active, and, if so, are you using birth control?
- B. Have you discussed taking these drugs with your parents?
- C. Which arm do you prefer to have an IV in for four (4) days?
- D. Have you signed an informed consent for investigational drugs?
Correct Answer: A
Rationale: Immunosuppressants are teratogenic, making contraception critical. Parental discussion, IV preference, and investigational consent are less relevant.
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