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While the nurse is completing the assessment of the child with Reye's syndrome, the parent states that multiple OTC medications were given before hospitalization to treat the child's influenza symptoms. Which medication stated by the parent is most important for the nurse to report to the HCP?
- A. Acetaminophen
- B. Bismuth subsalicylate
- C. Pseudoephedrine
- D. Diphenhydramine
Correct Answer: B
Rationale: A: Acetaminophen (Tylenol) is an aspirin-free analgesic and antipyretic. B: Although the etiology of Reye's syndrome is unknown, the condition typically occurs after a viral illness, such as influenza, and is associated with aspirin (acetylsalicylic acid) use during the illness. Bismuth subsalicylate (Pepto-Bismol) contains aspirin. C: Pseudoephedrine (Sudafed) is an allergy and/or cold remedy used for nasal drying and decongestion. This does not contain aspirin. D: Diphenhydramine (Benadryl) is an antihistamine. This does not contain aspirin.
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The client has been prescribed clonidine for the unlabeled purpose of easing the discomfort associated with smoking cessation. Which body system should be the nurse's initial focus when completing the client's physical assessment?
- A. Neurological
- B. Cardiovascular
- C. Gastrointestinal
- D. Musculoskeletal
Correct Answer: B
Rationale: Clonidine (Catapres) can cause hypotension and bradycardia, making the cardiovascular system the initial focus.
The 5-year-old is receiving an IV infusion of D5 with 0.45 NaCl at 100 mL/hr. Which assessment findings suggest excessive parenteral fluid intake? Select all that apply.
- A. Dyspnea
- B. Lethargy
- C. Gastric distention
- D. Crackles in lung bases
- E. Temperature of 102°F (38.9°C)
Correct Answer: A,B,D
Rationale: A: Dyspnea indicates fluid volume overload and occurs from fluid rapidly shifting between the intracellular and extracellular compartments. B: Lethargy and change in level of consciousness can occur from fluid shifting in brain cells. C: Gastric distention can occur from excessive oral (not IV) fluid intake or infection. D: Crackles indicate fluid volume overload and occur from fluid rapidly shifting into the alveoli. E: An elevated temperature is a sign of fluid volume deficit, not excess.
The LPN is about to give 100 mg Lopressor (metoprolol) to a client. Before administering the drug, he takes the patient's vitals, which are as follows: Pulse: 58, Blood Pressure: 90/62, Respirations: 18/minute. What action should the LPN take?
- A. Give the client half the prescribed dose and report the findings to the RN on duty.
- B. Give the client double the dose and report the findings to the RN on duty.
- C. Administer the drug and report the findings to the RN on duty.
- D. Hold the drug and report the findings to the RN on duty.
Correct Answer: D
Rationale: Lopressor is given to treat hypertension, and a pulse of 58 and a blood pressure of 90/62 are considered low. To prevent the client from bottoming out, the drug should be held and the findings reported to the RN, who should consult with the attending physician. LPNs should never adjust client dosing, as that is outside of their scope of practice.
Since taking the antidepressant doxepin, the female client has been reporting a decrease in sexual desire. She tells the nurse she “just isn't that interested†because she “just doesn't enjoy sex anymore.†She and her partner agree that they miss the excitement they used to share. Which is the most helpful response by the nurse?
- A. Perhaps you could try some alternatives to your normal sexual routines to enhance your sexual relationship.
- B. This often happens when couples are together for a longer period of time. Tell me how you would feel about a referral for counseling.
- C. This may be due to your medication. How would you feel about talking to your doctor about changing to a different type of antidepressant?
- D. Try to wait for a while. This is a temporary effect of your therapy, and as your depression gets better your interest in sexual activity should increase.
Correct Answer: C
Rationale: The most therapeutic response is to ask the client how she feels about contacting the HCP; switching to another antidepressant may be necessary if sexual dysfunction side effects become intolerable.
The LPN is caring for a client taking Lipitor (Atorvastatin). Which of these statements would indicate that the client may need reinforced teaching?
- A. I take my Lipitor with a glass of milk after my breakfast.
- B. I take my Lipitor and wait 30 minutes before taking my other medications.
- C. I take my Lipitor 30 minutes after I eat something.
- D. I take my Lipitor and my other morning medications with my grapefruit juice at breakfast.
Correct Answer: D
Rationale: Grapefruit juice should be avoided when taking Lipitor. Grapefruit juice blocks the enzymes needed to breakdown the drug, which leads to excessive amounts of the drug in the body.