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Thursday, August 7, 2008

Free Nclex Review Questions 9 (Nclex Answers)

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A nursing consideration for rubeola is eye care. The child usually has photophobia, so in planning for care, the nurse should suggest to the parent to keep the child out of brightly lit areas. Children with viral infections are not to be given aspirin because of the risk of Reye syndrome. Warm baths will aggravate itching.

Depositing the DTP vaccine deep into the muscle can reduce the irritating effect. Warming the vaccine may alter its chemical makeup. Adhering strictly to manufacturer’s temperature requirements is very important. Divided doses and a topical anesthetic may be used only with a physician’s order to do so.

Aspirin, an antiplatelet agent, inhibits prostaglandin synthesis and inhibits platelet aggregation. It is used to treat TIAs, ischemic stroke, angina, acute myocardial infarction, and rheumatologic conditions.

Fluid-volume status is a concern in the preoperative period of an infant with pyloric stenosis. Determining fluid-volume status provides information regarding the infant’s hydration needs. Preoperatively, important nursing responsibilities include strict monitoring of intake and output including intravenous infusion intake and monitoring urine specific gravity measurements. Weighing the infant's diapers provides information regarding output. Preoperatively, the infant is placed on a nothing-by-mouth (NPO) status. Enemas until clear would further compromise the fluid-volume status and would not be an option for an infant who most likely has a fluid-volume deficit.

During early therapy with cyclosporine, the client is most at risk of developing hypersensitivity reactions (wheezing, dyspnea, and flushing of the face and neck) and anaphylaxis. The nurse should be ready to manage this emergency by having oxygen and epinephrine readily available. A code cart also should be in close proximity.

Cyclosporine is an immunosuppressant medication. Because of the effects of the medication, the client should not receive any vaccinations without first consulting the physician. The client should report decreased urine output or cloudy urine, which could indicate either kidney rejection or infection, respectively. The client must be able to self-monitor blood pressure to check for the side effect of hypertension. The client needs dental examinations every 3 months for dental cleaning, which will help to prevent gingival hyperplasia. Meticulous oral care also will help control gingival hyperplasia.

Azathioprine is an immunosuppressant medication that is taken for life. Because of the effects of the medication, the client must monitor self for signs of infection, which are reported immediately to the health care provider. The client should also call the provider if more than one dose is missed. The medication may be taken with meals to minimize nausea.

Phenazopyridine is a urinary tract analgesic with no antimicrobial or antibacterial properties. It is used to relieve frequency, burning, or dysuria that follows urological procedures or accompanies infection. The medication is usually taken for 2 days as prescribed or until symptoms have resolved, and then is discontinued. Any accompanying antibiotics are continued until finished. It causes the urine to turn a reddish-orange color that can stain clothing and bedclothes permanently. This is a harmless side effect; however, female clients are advised to wear sanitary napkins to protect undergarments. The medication is best taken with food to avoid gastrointestinal upset.

Before plugging a cuffed tracheostomy tube, the cuff must be deflated. Otherwise, the client cannot ventilate around the tube and could experience respiratory arrest. Other correct nursing actions include suctioning the airway to promote ventilation and monitoring adequacy of oxygen saturation (baseline may vary slightly depending on the client). The client may have some residual abnormality on chest x-ray, depending on the client’s underlying pathology.

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