Nokea
You are working in a community pediatric health clinic. Which expected life transition should you apply into your practice for these pediatric clients as you are caring for pediatric clients of all ages?
- A. Pregnancy
- B. Puberty
- C. Childhood immunizations
- D. Separation anxiety
Correct Answer: B
Rationale: Puberty is a significant life transition for pediatric clients, particularly adolescents, and is relevant across the age range in a pediatric clinic. It involves physical, emotional, and social changes that nurses should consider in their practice.
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A client on a psychiatric care unit approaches the nurse and complains of muscle spasms in his neck, stiffness in other muscles, and that his eyes are rolling upward. The client had two p.r.n. doses of haloperidol (Haldol) in the last 6 hours. Of the drugs that have been ordered for the client as needed (see chart), the nurse should administer:
- A. Lorazepam (Ativan).
- B. Amantadine (Symmetrel).
- C. Diphenhydramine (Benadryl).
- D. Benztropine (Cogentin).
Correct Answer: D
Rationale: Dystonic adverse effects of haloperidol, especially oculogyric crises, are painful and frightening. I.M. benztropine is the fastest and most effective drug for managing dystonia. Lorazepam is an antianxiety medication and is not effective for treatment of dystonia. Although amantadine and diphenhydramine can be used for extrapyramidal symptoms, oral medications do not work as quickly, and amantadine may worsen psychotic symptoms.
A client with rheumatoid arthritis is prescribed methotrexate. Which laboratory value should the nurse monitor?
- A. Liver function tests.
- B. Serum glucose.
- C. Hemoglobin A1c.
- D. Serum calcium.
Correct Answer: A
Rationale: Methotrexate can cause hepatotoxicity, so monitoring liver function tests is essential.
A client is ready to be discharged from same-day surgery following an inguinal hernia repair. Which criteria must the client meet before the nurse can discharge the client?
- A. The client has transportation home via a taxicab.
- B. The client has pain no greater than 5 on a scale of 1 to 10.
- C. The client can walk to the bathroom by himself.
- D. The client states he will urinate later when he has more fluids.
Correct Answer: C
Rationale: The ability to walk to the bathroom indicates sufficient recovery of mobility and stability, a key discharge criterion. Pain control and urination are also important, but mobility is critical.
A Hispanic client is admitted to the surgical unit from the emergency department for an appendectomy. The nurse conducts the preoperative preparations and determines that the client has difficulty understanding English. The surgeon needs to obtain the client's informed consent. The nurse course for obtaining the client's informed consent is to:
- A. Have the client call a family member to act as interpreter
- B. Have the client sign the Spanish surgical consent form
- C. Call the Spanish interpreter to translate the surgeon's explanation of the procedure, risks, and alternatives to obtain the client's consent and to answer the client's questions
- D. Notify the surgical charge nurse of the situation
Correct Answer: C
Rationale: The surgeon is required to give the client explanations and have questions answered. The nurse has no way of assessing the client's understanding without the interpreter. The client should sign the Spanish consent form only after receiving an explanation of the procedure, its risks, and alternatives. A family member cannot be relied on to translate the surgeon's instructions accurately.
A client with a history of schizophrenia is prescribed clozapine (Clozaril). The nurse should monitor the client for which of the following adverse effects?
- A. Agranulocytosis.
- B. Hyperglycemia.
- C. Bradycardia.
- D. Hypotension.
Correct Answer: A
Rationale: Clozapine can cause agranulocytosis, requiring regular white blood cell monitoring.