NURS 172-Exam 4
The nurse is providing discharge teaching to a patient who has been diagnosed with a latex allergy. What should the nurse instruct the patient to avoid? a. Applying elastic bandages b. Eating leafy green vegetables c. Using cotton-tip applicators d. Putting on vinyl gloves
a
The nurse would assess a patient admitted with cellulitis for which of the following localized signs? a. Pain b. Fever c. Chills d. Malaise
a
To help identify the risk of exposing a patient to latex, healthcare providers should: a. Give patients a written or verbal questionnaire prior to treatment. b. Test a patient's latex sensitivity by touching his or her hand with latex gloves. c. Ask for a detailed family history to determine genetic predisposition to latex allergies. d. Ask patients if they are currently taking any allergy medications.
a
Which of the following instructions by the nurse is most appropriate for a client using contact lenses who is diagnosed with bacterial conjunctivitis? a. Discard all open or used lens care products b. Disinfect contact lenses by soaking in a cleaning solution for 48 hours. c. Put all cosmetics in a plastic bag for 1 week to kill any bacteria before using d. Disinfect all lens care products with the prescribed antibiotic for 1 week after infection
a
Which of the following interventions would be the most helpful in managing a patient newly admitted with cellulitis of the right foot? a. Applying warm, moist heat b. Limiting ambulation to three times daily c. Keeping the foot at or below heart level d. Wrapping the foot snugly in warm blankets
a
Which of the following laboratory results is the best indicator that a patient with cellulitis is recovering from this infection? a. WBC of 8200/ul b. WBC of 2900/ul c. WBC of 16,300/ul d. WBC of 12,700/ul
a
Following the insertion of tympanostomy tubes, offering liquid or soft foods keep the child from chewing is written on the postoperative plan of care. Which of the following nursing diagnoses would this intervention address? a. Hyperthermia related to infectious process. b. Risk for impaired skin integrity related to ear drainage. c. Pain related to the inflammatory process. d. Anxiety related to unfamiliar situation.
c
When receiving medical or dental treatment, individuals who suffer from latex allergy should: a. Refuse treatment in any office that uses rubber products. b. Wear a mask to prevent accidental inhalation or aerosol allergens. c. Inform healthcare providers of their allergy in advance. d. Wash their hands thoroughly with soap and water after treatment.
c
What possible complications can occur as a result of failing to treat head lice?
sores due to scratching hyper-pigmented, scaly skin, residual scaring scalp pruritus (itchy scalp)
Normal WBC
5,000-10,000
Ear drop administration
Adult-up and back Child-down and back
In a patient admitted with cellulitis of the left foot, which of the following clinical manifestations would you expect to find on assessment of the left foot? a. Redness and swelling b. Pallor and poor skin turgor c. Cyanosis and coolness d. Edema and brown skin discoloration
a
Individuals who have latex allergy are known to experience cross-sensitization to all of the following foods except: a. Corn b. Papayas c. Bananas d. Kiwis
a
Signs and Symptoms of SLE (Lupus)
-Tachypnea, cough, Pleural inflammation/effusion -Weight loss, Chronic fatigue -Fever--increased infection -Polyarthritis -Emotional lability -Hematologic disorders -increased coagulation -CNS disorders--seizures -Dysrhythmias, Raynaud's phenomenon, pericarditis, vascular inflammation -Butterfly rash over cheeks -Lupus nephritis, proteinuria, hematuria
What should be included in the educational plans for a child with head lice and her parents?
-screen all household members -have parents apply permethrin 1% lotion or shampoo on damp hair, and then wash with non-conditioner shampoo. Left on for 10 minutes and then rinse. use metal comb daily -repeat in 9 days -put stuffed animals in garbage bags for 2 weeks -boil brushes for 10 min or throw away
Patients with certain neurologic or cardiac complications from Lyme disease may need IV antibiotic therapy with ____ or ____
Ceftriaxone or Penicillin
Tympanostomy tubes fall out within ____ to ____ months.
6 to 12
Why is it important for the patient to have two EpiPen Auto Injections available at all times?
First injection only lasts 15-20 minutes, so a second pen might be needed
Signs and Symptoms of Lyme disease
Flu-like symptoms Insomnia Psychological complications Hearing loss Paralysis of face Heart complications Syncope, palpitations, dyspnea Hot, swollen, painful joints Bull's-eye rash at the site of tick bite--itching
The registered nurse is performing discharge teaching with the parents of a child who underwent placement of tympanostomy tubes. List what the nurse should include in this discharge teaching:
Monitor for signs and symptoms of infection follow-up care diet what the tube looks like keep head out of water
What bacteria is cellulitis caused by?
Staphylococcus aureas or streptococcus pneumoniae
Anaphylaxis is a potentially severe of life-threatening allergic reaction that can occur very quickly-as fast as within a couple of minutes of exposure to the allergen True or False
True
It is important for the patient to know to refill the EpiPen prescription before their EpiPen expires. True or False
True
The effects of an EpiPen only lasts 15-20 minutes True or False
True
When caring for a patient with a known latex allergy, the nurse would monitor the patient closely for a cross-sensitivity to which foods? (Select all that apply) a. Grapes b. Oranges c. Bananas d. Potatoes e. Tomatoes
a, c, d, e
Which of the following care measures should the nurse include when teaching home-care of a child who has bilateral bacterial conjunctivitis. (Select all that apply-3 correct answers) a. Use of warm, moist disposable compresses to remove crusting b. Use of oral antihistamine medication to relieve eye itching c. Use of topical anesthetics applied to relieve discomfort d. Teach the parents to administer the antibiotic eye medication e. Teach the child to wash hands frequently throughout the day
a, d, e
The mother calls you to ask what complications may occur with the head lice infestation. Which answer is correct? a. "Head lice are common carriers of impetigo." b. "Head lice are not known to transmit disease." c. "Head lice may transmit certain viral illnesses." d. "It is common to have a ringworm infection after a case of head lice."
b
The nurse is teaching a patient with a latex allergy about preventing and treating allergic reactions. Which statement, if made by the patient, indicates a need for further teaching? a. "My dentist should be told about my latex allergy." b. "My reactions are not severe; I will not need an EpiPen." c. "I should avoid foods such as bananas, avocados, and kiwi." d. "I will use vinyl gloves for activities such as housekeeping."
b
When developing the postoperative plan of care for a child who is scheduled to have a tympanostomy tube inserted into the right ear, which of the following interventions would the nurse identify to facilitate drainage? a. Applying warm compresses to the right ear. b. Positioning the child to lie on the right ear. c. Applying a gauze dressing to the left ear. d. Applying an ice pack to the left ear.
b
Clinical manifestations exhibited during an anaphylactic reaction include(Select all that apply, there are 5 correct answers): a. Hypertension b. Wheezing c. Dyspnea d. Urticaria (hives) e. Tachycardia f. Feeling of impending doom
b, c, d, e, f
Which statements are correct regarding the application of spinosad (Natroba)? a. Apply Natroba to wet hair. b. Shake bottle before using. c. Leave it on the scalp without rinsing for 24 hours. d. An adult needs to apply the medication. e. A second treatment, if needed, may be applied in 1 week. f. After the medications is washed off, use a fine-tooth comb to remove treated lice and nits from the scalp.
b, d, e, f
The mother asks which OTC eye drops would be best to use on her daughter's eyes for irritation. The most appropriate response by the nurse to the mother is: a. "Try on of the brand-name eye products available OTC for the conjunctivitis, instilling drops every 2 hours for 8 hours. Call back if the eyes do not clear up in 24 hours." b. Cleanse the eye with warm soap and water, and apply continuous warm compresses. Call back in 24 hours if the eyes have not improved." c. Cleanse the eyes using warm water and antibacterial soap, before applying an OTC water-soluble lubricant to each eye several times during waking hours." d. Cleanse the eyes from the inside to outside with a clean washcloth and warm water; wash hands carefully before and after care. The child should see her pediatrician within 24 hours."
d
What is the drug of choice for treating children experiencing anaphylaxis from a bee or wasp sting? a. Prednisone (Deltasone) b. Benadryl (diphenhydramine) c. Claritin (loratadine) d. Epinephrine (adrenalin)
d
What statement made by a parent would help make a child the most comfortable during the treatment of head lice? a. "I sure hope this works. I never thought this would happen." b. "Here is the shampoo. Be sure to scrub your head for several minutes." c. "It might be best to go ahead and cut your hair. It will grow back quickly." d. "We can pretend you're at the beauty parlor! Lean back while I wash your hair."
d
When teaching the parents of a 1-year-old child who is scheduled for placement of tympanostomy tubes, which of the following would the nurse include as the purpose for these tubes? a. Allow distribution of antibiotic solution into the middle ear. b. Assist in shrinking the mucosal lining of the middle ear. c. Increase pressure in the middle ear. d. Allow ventilation and drainage of the middle ear.
d
Why would head lice occur in school aged children?
direct contact playing and activities sharing hats, towels, clothes, etc.
Oral antibiotics used to treat early stage Lyme disease
doxycycline, cefuroxime, amoxicillin
Epinephrine (EpiPen) a. Can be administered through clothing b. Is expired if liquid is amber in color c. Should be administered in the outer thigh while holding for count of 3 d. Is available in two dosages: EpiPen (0.3mg) and EpiPen Junior (0.15mg) e. All of the above
e
What is pediculosis capitis?
head lice infestation
Anaphylactic reaction
rapid onset dyspnea feelings of apprehension tingling and swelling in mouth, face, throat, and tongue itching Decreased BP Tachycardia Loss of consciousness
