Extract:

Question 1 of 5

An adolescent tells the school nurse she thinks she has infectious mononucleosis. The nurse should next assess the client for?

Correct Answer: A

Rationale: Sore throat and malaise are hallmark symptoms of mononucleosis, requiring targeted assessment.

Question 2 of 5

The nurse is planning care for a client who has sustained a spinal cord injury. The nurse should assess the client for:

A. Anesthesia below the level of the injury. B. Tingling in the fingers. C. Pain below the site of the injury. D. Loss of position and vibratory sense.

Correct Answer: A,D

Rationale: Spinal cord injury often causes anesthesia (loss of sensation) and loss of position/vibratory sense below the injury level. Tingling or pain below the injury is less likely due to disrupted nerve pathways.

Question 3 of 5

A client with chronic undifferentiated schizophrenia is having an acute exacerbation of symptoms. The client states, 'Black cats and black hats. Where does the time go?' Which of the following would be most important for the nurse to say?

A. Halloween is getting close, isn't it.' B. Do you have a black cat?' C. What's the connection between cats, hats, and time?' D. Time certainly does go faster these days.'

Correct Answer: C

Rationale: Clarifying the client's statement helps assess their thought process and engage therapeutically.

Question 4 of 5

A client with a history of osteoporosis is prescribed alendronate (Fosamax). The nurse should instruct the client to take the medication:

A. At bedtime with a snack. B. First thing in the morning with water. C. With meals to enhance absorption. D. With milk to reduce stomach irritation.

Correct Answer: A

Rationale: Alendronate should be taken first thing in the morning with water, on an empty stomach, to maximize absorption and minimize esophageal irritation.

Question 5 of 5

The nurse calls the primary health care provider to express concerns about a chemotherapeutic medication dose prescribed by the primary health care provider being too high. The primary health care provider office informs the nurse that the primary health care provider has left town and will not be available for several days. What action should the nurse take next to assure client safety?

A. Reschedule the client's chemotherapy until the next week. B. Withhold giving the medication until the primary health care provider's partner makes rounds. C. Telephone the answering service and confer with the on-call primary health care provider. D. Confer with the pharmacist, who agrees the dose is too high, and then reduces the dose accordingly.

Correct Answer: C

Rationale: If the nurse believes a primary health care provider's prescription to be in error, the nurse must clarify the dosage with the client's primary health care provider or the primary health care provider's substitute before administering the medication. Rescheduling the client's chemotherapy is incorrect. Chemotherapy must be administered on a specific schedule for maximum effect with minimum adverse effects. Additionally, only a prescriber can withhold or reschedule chemotherapy. Withholding the medication until the partner makes rounds is incorrect. Chemotherapy agents must be administered in the proper combinations or sequence in order to be effective. Checking with the pharmacist can assist the nurse in determining whether the dose prescribed is incorrect, but the nurse or pharmacist cannot alter the dose without a revised prescription from a licensed primary health care provider with prescriptive authority.