Nokea
While assessing a client with degenerative joint disease, the nurse observes Heberden's nodes, large prominences on the client's fingers that are reddened. The client reports that the nodes are painful. Which action should the nurse take?
- A. Review the client's dietary intake of high-protein foods
- B. Notify the healthcare provider of the finding immediately
- C. Discuss approaches to the chronic pain control with the client
- D. Assess the client's radial pulses and capillary refill time
Correct Answer: C
Rationale: Chronic pain management is a priority in clients with degenerative joint disease and Heberden's nodes.
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On assessment of a child admitted with a diagnosis of Kawasaki Disease, the nurse expects to note which clinical manifestation of the acute phase of the disease?
- A. Cracked lips
- B. Normal appearance
- C. Conjuntival hyperemia
- D. Desquamation of the skin
Correct Answer: C
Rationale: Conjunctival hyperemia is a common clinical manifestation during the acute phase of Kawasaki Disease, characterized by redness of the eyes without discharge.
An adult male client is admitted for Pneumocystis carinii pneumonia (PCP) secondary to AIDS. While hospitalized, he receives IV pentamidine isethionate therapy. In preparing this client for discharge, what important aspect regarding his medication therapy should the nurse explain?
- A. IV pentamidine may offer protection to other AIDS-related conditions, such as Kaposi's sarcoma
- B. It will be necessary to continue prophylactic doses of IV or aerosol pentamidine every month
- C. IV pentamidine will be given until oral pentamidine can be tolerated
- D. AZT (Azidothymidine) therapy must be stopped when IV or aerosol pentamidine is being used.
Correct Answer: B
Rationale: Prophylactic doses of pentamidine are necessary to prevent PCP recurrence and other AIDS-related infections.
Following surgical repair of the bladder, a female client is being discharged from the hospital to home with an indwelling urinary catheter. Which instruction is most important for the nurse to provide to this client?
- A. Avoid coiling the tubing and keep if free of kinks
- B. Cleanse the perineal area with soap and water twice daily
- C. Keep the drainage bag lower than the level of the bladder
- D. Drink 1,000 ml of fluids daily to irrigate catheter
Correct Answer: C
Rationale: Keeping the drainage bag lower than the bladder prevents backflow of urine, reducing the risk of infection.
The parents of a young child with heart failure tell the nurse that they are “nervous†about giving digoxin (Lanoxin). The nurse’s response should be based on which statement?
- A. It is a safe, frequently used drug.
- B. It is difficult to either overmedicate or undermedicate with digoxin.
- C. Parents lack the expertise necessary to administer digoxin.
- D. Parents must learn specific, important guidelines for administration of digoxin.
Correct Answer: D
Rationale: Digoxin has a narrow therapeutic range. The margin of safety between therapeutic, toxic, and lethal doses is very small. Specific guidelines are available for parents to learn how to administer the drug safely and to monitor for side effects. Digoxin is a frequently used drug, but it has a narrow therapeutic range. Small amounts of the liquid are given to infants, making it easy to overmedicate or undermedicate. Parents may lack the necessary expertise to administer the drug at first, but with discharge preparation, they should be prepared to administer the drug safely.
Patients who have undergone surgery entailing the use of cardiopulmonary bypass should be watched carefully for
- A. epilepsy disabilities
- B. learning disabilities
- C. anemia
- D. arrhythmias
Correct Answer: D
Rationale: Arrhythmias are a common complication after cardiopulmonary bypass surgery.