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Questions 158

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Question 1 of 5

The home health nurse is visiting a client with Paget's disease. An important part of preventive care for the client with Paget's disease is:

Correct Answer: A

Rationale: Paget's disease weakens bones, increasing fracture risk. A clutter-free environment prevents falls, a key preventive measure. Dental care, vaccines, and vitamins are less specific.

Question 2 of 5

A client with Addison's disease has been receiving glucocorticoid therapy. Which finding indicates a need for dosage adjustment?

Correct Answer: C

Rationale: Rapid weight gain (6 pounds in a week) suggests fluid retention, a sign of glucocorticoid excess, requiring dosage adjustment. Dizziness may indicate underdosing, and the other symptoms are less specific.

Question 3 of 5

Which person is at greatest risk for developing Lyme disease?

Correct Answer: D

Rationale: Landscapers are at higher risk for Lyme disease due to frequent outdoor exposure in areas where ticks, which transmit the disease, are prevalent.

Question 4 of 5

A 67-year-old postoperative TURP client has hematuria. The nurse caring for him reviews his postoperative orders and recognizes that which one of the following prescribed medications would best relieve this problem?

Correct Answer: D

Rationale: Acetaminophen (Tylenol) has analgesic and antipyretic actions approximately equivalent to those of aspirin. It produces analgesia possibly by action on the peripheral nervous system. It reduces fever by direct action on the hypothalamus heat-regulating center with consequent peripheral vasodilation. It is generally used for temporary relief of mild to moderate pain, such as a simple headache, minor joint and muscle pains, and control of fever. Meperidine is a narcotic agonist analgesic with properties similar to morphine except that it has a shorter duration of action and produces less depression of urinary retention and smooth muscle spasm. It is used for moderate to severe pain, for a preoperative medication, for support of anesthesia, and for obstetrical analgesia. In a postoperative TURP client, it would be used in conjunction with other medications for relief of moderate to severe pain, but not specifically for bladder spasms associated with TURP surgery. Promethazine hydrochloride is an antihistamine, antiemetic preparation. It exerts antiserotonin, anticholinergic, and local anesthetic actions. It is used for symptomatic relief of various allergic conditions, motion sickness, nausea, and vomiting. It is used for preoperative, postoperative, and obstetrical sedation and as an adjunct to analgesics for control of pain. This answer is correct because aminocaproic acid is prescribed specifically for hematuria. Aminocaproic acid is excreted in the urine. The nurse should be alert for possible signs of thrombosis, particularly in the extremities.

Question 5 of 5

The client with a history of gout is prescribed allopurinol (Zyloprim). The nurse should instruct the client to:

Correct Answer: B

Rationale: Allopurinol reduces uric acid production, and taking it with a full glass of water promotes excretion of uric acid, preventing kidney stones. Fluid restriction is harmful, calcium is not restricted, and it can be taken with food.

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