A young male client visits a nurse with a complaint of chronic tension headaches. Which of the ff is the most appropriate nursing instruction to manage the client?

Correct Answer: C

Rationale: The most appropriate nursing instruction to manage a young male client with chronic tension headaches is counseling on alternate therapies. Chronic tension headaches can be caused or exacerbated by various factors such as stress, poor posture, eyestrain, or muscular tension. Counseling on alternate therapies can include techniques such as relaxation exercises, stress management strategies, mindfulness practices, physical therapy, or massage therapy. These alternative therapies can help the client manage stress, improve posture, and reduce muscle tension, which may help alleviate the frequency or intensity of tension headaches. It is important to explore non-pharmacological approaches before considering medication, especially for chronic conditions like tension headaches.

Correct Answer: B

Rationale: The nurse should advise the client and her family members to apply insect repellent to clothing and exposed skin to prevent insect bites in the future. Insect repellents containing DEET, picaridin, or oil of lemon eucalyptus are effective in repelling mosquitoes, ticks, and other insects that may cause bites. By regularly applying insect repellent, they can reduce the risk of getting bitten and prevent a recurrence of the ailment. Other preventive measures such as wearing long sleeves and pants, avoiding heavily wooded or grassy areas, and using screens on windows and doors can also be beneficial in preventing insect bites.

Correct Answer: B

Rationale: Levodopa is the antiparkinsonian drug associated with the on-off phenomenon and the wearing-off effect. The on-off phenomenon refers to the sudden and unpredictable fluctuations between periods of symptom control (on) and periods of symptom re-emergence (off) in patients with Parkinson's disease receiving levodopa therapy. This can happen as the disease progresses and the brain becomes less responsive to the medication.

Correct Answer: B

Rationale: In the Rinne test, a tuning fork is placed first on the mastoid bone behind the ear to test bone conduction, and then beside the ear to test air conduction. A normal finding in the Rinne test is when air conduction (heard beside the ear) is longer than bone conduction (heard on the mastoid bone) in both ears. This indicates that sound waves travel through the air better than through bone. If air conduction is heard longer than bone conduction, it suggests normal auditory acuity.

Correct Answer: D

Rationale: In the syndrome of inappropriate antidiuretic hormone (SIADH), there is an excessive release of antidiuretic hormone (ADH), leading to water retention by the kidneys and dilution of electrolytes in the blood. This can result in hyponatremia and fluid overload. Therefore, the appropriate nursing intervention for a client with SIADH is to restrict fluids to help prevent further fluid retention and worsening of hyponatremia. Infusing IV fluids rapidly, administering glucose-containing IV fluids, or encouraging increased oral fluid intake would exacerbate the problem by further diluting the electrolyte concentration in the blood. By restricting fluids, the aim is to maintain a strict intake and output balance to promote a gradual increase in serum sodium levels and help restore normal fluid balance in the body.