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The nurse is reinforcing teaching with the parents of a child diagnosed with impetigo. Which of the following statements, if made by the parent, would indicate effective understanding
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It is the most common bacterial skin infection between the ages of 2 and 5.
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The torso is the area most commonly affected by impetigo.
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The causative agent of impetigo is Haemophilus influenzae.
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Impetigo is usually not a systemic infection.
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I should keep my child home from swim practice until the blisters heal.
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I should not share my child's linens with anyone else in the house.
Explanation
Correct Answers:
A. It is the most common bacterial skin infection between the ages of 2 and 5.
D. Impetigo is usually not a systemic infection.
E. I should keep my child home from swim practice until the blisters heal.
F. I should not share my child's linens with anyone else in the house.
Explanation:
Impetigo is a common superficial skin infection most frequently affecting children between 2 and 5 years old. It is typically localized and does not lead to systemic symptoms unless complications occur. Because the condition is highly contagious, activities like swimming should be avoided until the lesions are healed. Additionally, household items like linens should not be shared to prevent spreading the infection to others.
Why Other Options Are Wrong:
B. The torso is the area most commonly affected by impetigo.
Incorrect. Impetigo most often affects the face, particularly around the nose and mouth, as well as the extremities.
C. The causative agent of impetigo is Haemophilus influenzae.
Incorrect. The typical causative agents of impetigo are Staphylococcus aureus and Streptococcus pyogenes, not Haemophilus influenzae.
When assessing a client who has been ordered skeletal traction, the assessment reveals her foot is pale, cool, and her pulse is not palpable. What is the priority nursing intervention
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Reassess the foot in twenty minutes.
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Readjust the traction.
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Administer the ordered as-needed medication.
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Notify the physician.
Explanation
Correct Answer D. Notify the physician.
Explanation:
D. Notify the physician.
The findings of a pale, cool foot with an absent pulse are signs of compromised circulation, which may indicate acute compartment syndrome or vascular occlusion. These are surgical emergencies that require immediate evaluation to prevent permanent tissue damage or limb loss. The priority is to report these signs to the healthcare provider without delay.
Why Other Options Are Wrong:
A. Reassess the foot in twenty minutes.
Waiting could delay essential interventions. Delaying action in the presence of critical circulatory compromise may result in irreversible damage.
B. Readjust the traction.
LPNs and bedside nurses should not adjust skeletal traction themselves without a prescription due to the risk of displacing hardware and worsening injury.
C. Administer the ordered as-needed medication.
Giving pain medication may mask symptoms and delay necessary surgical or vascular intervention. It does not address the underlying perfusion issue.
A newly admitted client describes symptoms of dizziness and feeling faint on standing. The client has a history of type 2 diabetes, coronary artery disease, and bipolar disorder. Which medications may be contributing to the client's symptoms
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Atorvastatin
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Metformin
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Metoprolol
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Olanzapine
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Omeprazole
Explanation
Correct Answers:
C. Metoprolol
D. Olanzapine
Explanation of Each Correct Answer:
C. Metoprolol
Metoprolol is a beta-blocker that lowers heart rate and blood pressure. It can lead to orthostatic hypotension, especially when a person moves from lying to standing, causing dizziness or feeling faint.
D. Olanzapine
Olanzapine is an atypical antipsychotic commonly used to treat bipolar disorder. A known side effect is orthostatic hypotension, particularly when starting or increasing the dose, leading to dizziness or lightheadedness upon standing.
The nurse is observing a staff member preparing to exit the room of a client who requires airborne precautions. The nurse should intervene if the staff member is observed removing the
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Eye goggles with ungloved hands
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Protective gown with ungloved hands
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Gloves prior to removal of the N95 respirator mask
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N95 respirator mask prior to removal of the protective gown
Explanation
Correct Answer D. N95 respirator mask prior to removal of the protective gown
Explanation:
When exiting a room with airborne precautions, it is critical to remove personal protective equipment (PPE) in a specific order to prevent contamination. The N95 respirator mask should be removed after the protective gown. This is because the mask is designed to filter out airborne particles, and removing it before the gown increases the risk of contaminating the healthcare worker’s face and respiratory tract. The proper sequence is to first remove the protective gown and then the N95 mask to ensure that any airborne particles trapped on the gown do not come in contact with the face.
The nurse is caring for a client with left-sided weakness from a stroke. When assisting the client to a chair, what should the nurse do
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Bend at the waist
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Keep the feet close together
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Pivot on the foot proximal to the chair
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Use a transfer belt
Explanation
Correct Answer D. Use a transfer belt
Explanation of the Correct Answer:
A transfer belt (gait belt) is an essential safety tool when moving a client with limited mobility or weakness, such as one recovering from a stroke. It provides the nurse with better leverage and control during the transfer and helps prevent falls or injury to both the nurse and the client. It also promotes safe body mechanics during assisted mobility.
The client states, "I would sleep better if those mice and cats would stop climbing up and down the walls."
The upper portion of the client's dressing is saturated with yellowish-green drainage. The peripheral IV
was removed by the client, and dried blood is noted at the IV site. The IV catheter is on the floor. The
client yelled and pushed the nurse's hands away during inspection of the IV site.
Vital signs: T 99 F (37.2 C), P 102, RR 18, BP 170/96, SpO2 95% on room air
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Client is trembling, diaphoretic, and restless
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Client reports seeing “mice and cats” climbing on the walls (visual hallucinations)
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Client yelled and pushed the nurse away during assessment
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Peripheral IV was removed by the client; catheter is on the floor
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Upper portion of dressing saturated with yellowish-green drainage
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Elevated blood pressure: 170/96
Explanation
Explanation:
These seven findings are critical because they indicate a combination of infection, possible sepsis, delirium or substance withdrawal, and disruption of treatment. Tremors, diaphoresis, restlessness, and hallucinations are signs of acute delirium or substance withdrawal (such as alcohol), both of which require urgent medical intervention to prevent worsening agitation, seizures, or complications. The dried blood raise concern for self-harm, infection risk, and lack of access for necessary treatments like antibiotics or fluids. A saturated dressing with yellowish-green drainage indicates a worsening or uncontrolled infection, and failure to address this could lead to systemic spread. Lastly, a blood pressure of 170/96 may reflect a stress response or hypertensive urgency, requiring prompt evaluation. All findings combined suggest the client is deteriorating and needs immediate medical follow-up to address both physical and mental health risks.
The practical nurse cares for a patient with hypokalemia and accelerated hypertension. The physician has listed the cause as hyperaldosteronism. Which of the following endocrine disorders causes increased aldosterone
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Cushing's disease
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Addison's disease
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Conn's syndrome
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Pheochromocytoma
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Crohn's disease
Explanation
Correct Answers:
A. Cushing's disease
C. Conn's syndrome
Explanation:
Hyperaldosteronism results from excessive secretion of aldosterone, a hormone that promotes sodium retention and potassium excretion. This leads to hypertension and hypokalemia. Conn's syndrome is primary hyperaldosteronism caused by an adrenal adenoma or hyperplasia that produces aldosterone independently of the renin-angiotensin system. Cushing's disease, caused by excess adrenocorticotropic hormone (ACTH), can lead to increased cortisol and, to a lesser extent, increased aldosterone production, contributing to fluid retention and hypertension.
Why Other Options Are Wrong:
B. Addison's disease
This is a condition of adrenal insufficiency, in which both cortisol and aldosterone levels are reduced. Clients with Addison's disease typically present with hypotension, hyperkalemia, and hyponatremia—opposite to the effects of hyperaldosteronism.
D. Pheochromocytoma
This tumor causes excessive catecholamine release (epinephrine and norepinephrine), leading to episodic hypertension, but it does not directly increase aldosterone levels. The hypertension is due to vasoconstriction, not sodium retention.
E. Crohn's disease
This is a gastrointestinal autoimmune disorder, not an endocrine condition. It does not affect aldosterone production. Electrolyte imbalances in Crohn’s may be due to malabsorption or diarrhea, but not hormonal causes.
The nurse is collecting data from a client with Bell palsy. Which of the following findings would the nurse expect to observe
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Inability to smile symmetrically
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Frequent blinking of the affected eye
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Shock-like pain in the lips and gums
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Loss of forehead and brow movements
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Decreased lacrimation on the affected side
Explanation
Correct Answers:
A. Inability to smile symmetrically
D. Loss of forehead and brow movements
E. Decreased lacrimation on the affected side
Explanation of Each Correct Answer:
A. Inability to smile symmetrically
Bell palsy causes unilateral facial paralysis due to dysfunction of the facial nerve (cranial nerve VII). Clients cannot control muscles on the affected side, resulting in an asymmetrical smile.
D. Loss of forehead and brow movements
Unlike strokes (which often spare the forehead), Bell palsy affects both the upper and lower facial muscles on the affected side. Clients cannot raise their eyebrows or wrinkle their forehead on that side.
E. Decreased lacrimation on the affected side
Since the facial nerve controls tear production via the lacrimal gland, Bell palsy may reduce tear production, leading to dryness or irritation in the affected eye.
The licensed practical/vocational nurse (LPN/VN) reviews newly prescribed medications for a client taking prescribed lithium. Which medication requires further follow-up by the LPN/VN
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venlafaxine
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hydrochlorothiazide
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gabapentin
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losartan
Explanation
Correct Answer B. hydrochlorothiazide
Explanation:
Hydrochlorothiazide requires follow-up because it can significantly increase the risk of lithium toxicity. Thiazide diuretics reduce renal clearance of lithium by promoting sodium loss; since lithium and sodium are processed similarly by the kidneys, decreased sodium levels cause the body to retain lithium. This can lead to dangerously high lithium levels, even when taken at prescribed doses. Monitoring and possibly adjusting lithium dosage is necessary when starting or changing thiazide diuretic therapy.
Why Other Options Are Wrong:
A. venlafaxine
Venlafaxine is an SNRI antidepressant, and while care must be taken when combining antidepressants with mood stabilizers, it does not directly interfere with lithium excretion or raise its serum levels. Still, the combination may be used cautiously under supervision, especially in treatment-resistant depression or bipolar disorder.
C. gabapentin
Gabapentin is used as an anticonvulsant and for neuropathic pain and is often co-prescribed with lithium without significant interaction. It does not affect lithium metabolism or renal clearance and generally does not require dose adjustment when used concurrently.
D. losartan
Losartan is an angiotensin II receptor blocker used for hypertension. While certain antihypertensives may affect renal function, losartan does not have the same lithium-retaining effects as thiazide diuretics. However, periodic monitoring of kidney function and lithium levels is still appropriate.
Which of the following statements indicates body image distortion in a client with anorexia nervosa
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I'm so overweight.
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I'm trying to eat healthier so I can feel better.
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My doctor says I'm underweight, but I don’t believe them.
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I feel bloated even though I haven’t eaten all day.
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I think my weight is just right for my height.
Explanation
Correct Answers:
A. I'm so overweight.
C. My doctor says I'm underweight, but I don’t believe them.
D. I feel bloated even though I haven’t eaten all day.
Explanation:
Clients with anorexia nervosa often experience body image distortion, meaning their perception of their body does not match reality. Despite being underweight, they may believe they are fat, bloated, or unattractive. These thoughts and beliefs fuel restrictive behaviors and are a core part of the disorder.
A. I'm so overweight.
This is a classic example of body image distortion in anorexia. The client perceives themselves as overweight despite being underweight.
C. "My doctor says I'm underweight, but I don’t believe them.
Denial of being underweight shows distorted thinking and lack of insight into their true physical condition.
D. I feel bloated even though I haven’t eaten all day.
Feeling bloated without food intake is a sign of distorted perception, common in anorexia nervosa.
Why Other Options Are Incorrect:
B. I'm trying to eat healthier so I can feel better.
This statement reflects a goal-oriented, health-conscious mindset and does not suggest body image distortion.
E. I think my weight is just right for my height.
This reflects a realistic or neutral body image perception and would not indicate distortion.
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