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NEW QUESTION 30
A 5-year-old child was recently diagnosed as having acute lymphoid leukemia. She is hospitalized for additional tests and to begin a course of chemotherapy designed to induce a remission. She is scheduled to have a bone marrow aspiration tomorrow. She has had a bone marrow test previously and is apprehensive about having another. Which of the following interventions will be most effective in relieving her anxiety?

A. Explain what will take place and what she will see, feel, and hear.B. Tell her not to worry about it, that it will be over soon and she can join her friends in the playroom.C. Give her a big hug and tell her that she is a big girl now and that she will do just fine.D. Remind her that she has had this procedure before and that it is nothing to be afraid of.

Answer: A

Explanation:
Section: Questions Set D
Explanation
Explanation:
(A) Even though the child has had the procedure before, she will probably need additional explanations and emotional support. (B) The fact that the child has had the procedure before and possibly found it painful or uncomfortable may increase, not relieve, her stress. (C) This intervention does nothing to reassure the child and may well prevent her from expressing her feelings. (D) This does not prepare the child for the test and burdens her with the expectation that she act bigger and braver than she is.

 

NEW QUESTION 31
The nurse caring for a client who has pneumonia, which is caused by a gram-positive bacteria, inspects her sputum. Because the client's pneumonia is caused by a gram-positive bacteria, the nurse experts to find the sputum to be:

A. Pink-tinged and frothyB. Rust coloredC. Green coloredD. Bright red with streaks

Answer: B

Explanation:
Explanation
(A) Bright red sputum with streaks is associated with pneumonia caused by gram-negative bacteria, such asKlebsiellapneumonia. (B) Pneumococcal pneumonia, caused by gram-positive bacteria, has a characteristic productive cough with green or rust-colored sputum. (C) Green-colored sputum is more characteristic ofPseudomonasthan of gram-positive bacterial pneumonia. (D) Pink-tinged and frothy sputum is more characteristic of pulmonary edema than of gram-positive bacterial pneumonia.

 

NEW QUESTION 32
A male client has been hospitalized with congestive heart failure. Medical management of heart failure focuses on improving myocardial contractility. This can be achieved by administering:

A. Nitroglycerin (Nitrol) 1 inch topically every 4 hoursB. Digoxin (Lanoxin) 0.25 mg po every dayC. Furosemide (Lasix) 40 mg po every morningD. O22 L/min via nasal cannula

Answer: B

Explanation:
(A) Digoxin is a cardiac glycoside given to clients in heart failure to improve their myocardial contractility. (B) Furosemide is a loop diuretic given to clients in heart failure to promote diuresis. (C) O2is given to clients in heart failure to increase oxygenation and to prevent or treat hypoxemia. (D) Nitroglycerin is a nitrate given to clients in heart failure to increase their cardiac output by decreasing the peripheral resistance that the left ventricle must pump against.

 

NEW QUESTION 33
A female client has experienced varying degrees of depression throughout her life. Now that she is postmenopausal, her depression has increased. She is unable to motivate herself to clean her house or even to get out of bed and get dressed in the morning. The client was begun on fluoxetine (Prozac) therapy. When educating her about fluoxetine, what might the nurse caution her about?

A. A daily dose of fluoxetine may be taken in the morning or evening.B. Fluoxetine is not sedating; therefore, restrictions on driving and other hazardous activities are not necessary.C. It is safe to take over-the-counter or other prescription medications with fluoxetine.D. Rashes or pruritus usually occur early in the therapy and are treatable without discontinuing the medication.

Answer: D

Explanation:
Explanation/Reference:
Explanation:
(A) A daily dose of fluoxetine should be taken in the morning. Afternoon doses may cause nervousness and insomnia. (B) Although fluoxetine is less sedating than other antidepressants, it may still cause dizziness or drowsiness in some clients. The nurse should caution clients to avoid driving or hazardous activities until the central nervous system effects of the drug are demonstrated. (C) Rashes or pruritus do commonly occur early in therapy and respond to antihistamines or topical corticosteroids. (D) Advise the client not to take over-the-counter or other prescription drugs without consulting with the physician.
Fluoxetine does interact with other common drugs such as monoamine oxidase inhibitors, diazepam, insulin, oral antidiabetic agents, tricyclic antidepressants, and tryptophan.

 

NEW QUESTION 34
For the past several months, an elderly female client with Alzheimer's disease has experienced paranoia; hallucinations; and aggressive, disruptive behavior. The family is utilizing haloperidol as needed to control her behavior. On nursing assessment, you note that the client demonstrates involuntary movements of the tongue and fingers. This may most likely indicate:

A. The need to change her medication from haloperidol to another antipsychotic drug to lessen symptomsB. Tardive dyskinesia, which may be a side effect of antipsychotic medicationC. Early symptoms of Parkinson's diseaseD. A more advanced stage of Alzheimer's disease than previously experienced by the client

Answer: B

Explanation:
Explanation/Reference:
Explanation:
(A) Tardive dyskinesia is a common side effect of antipsychotic medications such as haloperidol.
Discontinuing the medication can alleviate symptoms. (B) Although mild tremors are an early sign of Parkinson's disease, haloperidol must be discontinued first and the client further evaluated. (C) These symptoms do not necessarily indicate a more advanced stage of Alzheimer's disease. (D) Most antipsychotic drugs are chemically similar and will produce the same side effects.

 

NEW QUESTION 35
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