The physician has prescribed a Flovent (fluticasone) inhaler two puffs twice a day for a client with chronic obstructive pulmonary disease. The nurse should tell the client to report:
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Solution
Answer B is correct. Clients who use steroid medications, such as fluticasone, can develop adverse side effects, including oral infections with candida albicans. Symptoms of candida albicans include sore throat and white patches on the oral mucosa. Increased weight, difficulty in sleeping, and changes in mood are expected side effects; therefore, answers A, C, and D are incorrect.
Which one of the following symptoms is common in the client with duodenal ulcers?
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Solution
Answer D is correct. Melena, or blood in the stool, is common in the client with duodenal ulcers. Answers A and B are symptoms of gastric ulcers; therefore, they are incorrect. Diarrhea is not a symptom of duodenal ulcers; therefore, answer C is incorrect.
A client receiving chemotherapy has Sjogren’s syndrome. The nurse can help relieve the discomfort caused by Sjogren’s syndrome by:
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Solution
Answer B is correct. The client with Sjogren’s syndrome complains of dryness of the eyes. The nurse can help relieve the client’s discomfort by instilling eyedrops. Answers A, B, and C do not relieve the symptoms of Sjogren’s syndrome; therefore, they are incorrect.
A client with AIDS tells the nurse that he regularly takes Echinacea to boost his immune system. The nurse should tell the client that:
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Solution
Answer A is correct. Herbals such as Echinacea can interfere with the action of antiviral medications; therefore, the client should discuss the use of herbals with his physician. Answer B is incorrect because supplements have not been shown to prolong life. Answer C is incorrect because herbals have not been shown to be effective in decreasing the viral load. Answer D is incorrect because supplements do not prevent replication of the virus.
While caring for a client following a Whipple procedure, the LPN notices that the drainage has become bile tinged and has increased over the past hour. The LPN should:
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Solution
Answer D is correct. The appearance of increased drainage that is clear, colorless, or bile tinged indicates disruption or leakage at one of the anastamosis sites, which requires immediate attention. Answer A is incorrect because the client’s condition will worsen without prompt intervention. Answers B and C are incorrect choices because they cannot be performed without a physician’s order.
The nurse is caring for a client with a basal cell epithelioma. The nurse recognizes that the risk factors for basal cell carcinoma include having fair skin and:
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Solution
Answer A is correct. Basal cell epithelioma, skin cancer, is related to sun exposure. Answers B, C, and D are incorrect because they are not associated with the development of basal cell epithelioma.
A client with AIDS-related cytomegalovirus has been started on Cytovene (ganciclovir). The client asks the nurse how long he will have to take the medication. The nurse should tell the client that the medication will be needed:
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Solution
Answer D is correct. The medication must be taken for the remainder of the client’s life to prevent the reoccurrence of CMV infection. Answers A, B, and C are inaccurate statements; therefore, they are incorrect.
A nurse finds her neighbor lying unconscious in the doorway of her bathroom. After determining that the victim is unresponsive, the nurse should:
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Solution
Answer D is correct. According to the American Heart Association, the nurse should call for help before instituting CPR. Answer A is incorrect because the nurse would first call for help. The nurse would not start cardiac compressions before evaluating the client’s carotid pulse. Answer B is incorrect because the nurse would first call for help. The nurse would not administer rescue breathing until she established that the client was not breathing on her own. Answer C is incorrect because the nurse would open the airway after calling for help.
The Joint Commission for Accreditation of Hospital Organizations (JCAHO) specifies that two client identifiers are to be used before medication administration. Which method is best for identifying patients using two patient identifiers?
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Solution
Answer A is correct. JCAHO guidelines state that at least two client identifiers should be used whenever administering medications or blood products, whenever samples or specimens are taken, and when providing treatments. Neither of the identifiers is to be the client’s room number. Answer B is incorrect because the client’s room number is not used as an identifier. Answer C and D are incorrect because the best identifiers according to JCAHO are the client’s armband, medical record number, and/or date of birth.
The LPN is assigned to care for a client with a fractured femur. Which of the following should be reported to the charge nurse immediately?
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Solution
Answer A is correct. Complaints of chest pain and feelings of apprehension are associated with pulmonary emboli, which can occur after the fracture of long bones. These findings should be reported immediately so that interventions can begin. Answer B is incorrect because ecchymosis is common following fractures. Answer C is incorrect because a low-grade temperature is expected because of the inflammatory response. Answer D is incorrect because Level 2 pain is expected in the client with a recent fracture.