The nurse is caring for a client admitted with suspected myasthenia gravis. Which finding is usually associated with a diagnosis of myasthenia gravis?
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Solution
Answer D is correct. The client with myasthenia develops progressive weakness that worsens during the day. Answer A is incorrect because it refers to symptoms of multiple sclerosis. Answer B is incorrect because it refers to symptoms of Guillain Barre syndrome. Answer C is incorrect because it refers to Parkinson’s disease.
A client with diabetes mellitus has a prescription for Glucotrol XL (glipizide). The client should be instructed to take the medication:
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Solution
Answer B is correct. Glucotrol XL is given once a day with breakfast. Answer A is incorrect because the client would develop hypoglycemia while sleeping. Answers C and D are incorrect because the client would develop hypoglycemia later in the day or evening.
The physician has discussed the need for medication with the parents of an infant with congenital hypothyroidism. The nurse can reinforce the physician’s teaching by telling the parents that:
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Solution
Answer B is correct. The medication will be needed throughout the child’s lifetime. Answers A, C, and D contain inaccurate statements; therefore, they are incorrect.
The nurse has taken the blood pressure of a client hospitalized with methicillin-resistant staphylococcus aureus. Which action by the nurse indicates an understanding regarding the care of clients with MRSA?
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Solution
Answer A is correct. The stethoscope should be left in the client’s room for future use. The stethoscope should not be returned to the exam room or the nurse’s station; therefore, answers B and D are incorrect. The stethoscope should not be used to assess other clients; therefore, answer C is incorrect.
An obstetrical client calls the clinic with complaints of morning sickness. The nurse should tell the client to:
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Solution
Answer A is correct. Eating a carbohydrate source such as dry crackers or toast before arising helps alleviate symptoms of morning sickness. Answer B is incorrect because the additional fat might increase the client’s nausea. Answer C is incorrect because the client does not need to skip meals. Answer D is the treatment of hypoglycemia, not morning sickness; therefore, it is incorrect.
An 18-month-old is being discharged following hypospadias repair. Which instruction should be included in the nurse’s discharge teaching?
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Solution
Answer A is correct. The child will need to avoid straddle toys, swimming, and rough play until allowed by the surgeon. Answers B, C, and D do not relate to the post-operative care of the child with hypospadias; therefore, they are incorrect.
The nurse has been teaching the role of diet in regulating blood pressure to a client with hypertension. Which meal selection indicates that the client understands his new diet?
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Solution
Answer C is correct. Oatmeal is low in sodium and high in fiber. Limiting sodium intake and increasing fiber helps to lower cholesterol levels, which reduce blood pressure. Answer A is incorrect because cornflakes and whole milk are higher in sodium and are poor sources of fiber. Answers B and D are incorrect because they contain animal proteins that are high in both cholesterol and sodium.
A client is hospitalized with hepatitis A. Which of the client’s regular medications is contraindicated due to the current illness?
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Solution
Answer D is correct. Lipid-lowering agents are contraindicated in the client with active liver disease. Answers A, B, and C are incorrect because they are not contraindicated in the client with active liver disease.
The mother of a child with cystic fibrosis tells the nurse that her child makes “snoring” sounds when breathing. The nurse is aware that many children with cystic fibrosis have:
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Solution
Answer B is correct. Children with cystic fibrosis are susceptible to chronic sinusitis and nasal polyps, which might require surgical removal. Answer A is incorrect because it is a congenital condition in which there is a bony obstruction between the nares and the pharynx. Answers C and D are not specific to the child with cystic fibrosis; therefore, they are incorrect.
The physician has ordered Stadol (butorphanol) for a postoperative client. The nurse knows that the medication is having its intended effect if the client:
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Solution
Answer A is correct. Stadol reduces the perception of pain, which allows the post-operative client to rest. Answers B and C are not affected by the medication; therefore, they are incorrect. Relief of pain generally results in less nausea, but it is not the intended effect of the medication; therefore, answer D is incorrect.