Which instruction would the nurse include in a teaching plan for a client with scleroderma skin care

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    Terms in this set (30)

    A nurse is counseling a client who has gonorrhea. What additional fact about gonorrhea, besides the fact that it is highly infectious, should the nurse teach this client?

    1.It is easily cured.
    2.It occurs very rarely.
    3.It can produce sterility.
    4.It is limited to the external genitalia

    3.It can produce sterility.

    A client with a recent history of sinusitis develops meningitis and demonstrates a positive Brudzinski sign. The priority nursing care is:

    1.Controlling intracranial pressure
    2.Adding pads to the side of the bed
    3.Administering prescribed antibiotics
    4.Hydrating the client with hypotonic saline

    3.Administering prescribed antibiotics

    A nurse is preparing a teaching plan for a client with syphilis. The nurse includes that syphilis is not considered contagious in the:

    1.Tertiary stage
    2.Primary stage
    3.Secondary stage
    4.Incubation stage

    1.Tertiary stage

    A client is admitted to the hospital for general paresis as a complication of syphilis. Which therapy should the nurse anticipate will most likely be prescribed for this client?

    1.Penicillin therapy
    2.Major tranquilizers
    3.Behavior modification
    4.Electroconvulsive therapy

    1.Penicillin therapy

    A client arrives for a vaccination at an influenza prevention clinic. A nursing assessment identifies a current febrile illness with a cough. The nurse should:

    1.Give the vaccine
    2.Administer aspirin with the vaccine
    3.Hold the vaccine and notify the health care provider
    4.Reschedule administration of the vaccine for the next month

    4.Reschedule administration of the vaccine for the next month

    The nurse cares for a client who develops pyrexia three days after surgery. The nurse should monitor the client for which signs and symptoms commonly associated with pyrexia? (Select all that apply.)

    1.Dyspnea
    2.Chest pain
    3.Tachypnea
    4.Increased pulse rate
    5.Elevated blood pressure

    3.Tachypnea
    4.Increased pulse rate

    A client is admitted with the diagnosis of tetanus. For which clinical indicators should the nurse assess the client? (Select all that apply.)

    1.Restlessness
    2.Muscular rigidity
    3.Atony of facial muscles
    4.Respiratory tract spasms
    5.Spastic voluntary muscle contractions

    1.Restlessness
    2.Muscular rigidity
    4.Respiratory tract spasms
    5.Spastic voluntary muscle contractions

    A client expresses concern that because of supply and demand there is no vaccine available for the annual flu vaccine. What is the nurse's best reply?

    1."It's unfortunate, but there was such a limited supply available."
    2."There are many others who also were unable to get a flu vaccine."
    3."It doesn't matter because the vaccine is for just one particular strain."
    4."There are other things you can do to prevent the flu, such as hand washing."

    4."There are other things you can do to prevent the flu, such as hand washing."

    The nurse teaches a group of clients that nutritional support of natural defense mechanisms indicates the need for a diet high in:

    1.Essential fatty acids
    2.Dietary cellulose and fiber
    3.Tryptophan, an amino acid
    4.Vitamins A, C, E, and selenium

    4.Vitamins A, C, E, and selenium

    A client scheduled for surgery has a history of methicillin-resistant Staphylococcus aureus (MRSA) since developing an infection in a surgical site nine months ago. The site is healed and the client reports having received antibiotics for the infection. What should the nurse do to determine if the infecting organism is still present?

    1.Notify the infection control officer
    2.Inform the operating room of the MRSA
    3.Obtain a prescription to culture the client's blood
    4.Call the surgeon for an infectious disease consultation

    3.Obtain a prescription to culture the client's blood

    A nurse is developing a teaching plan for a client with scleroderma. What should the nurse include about skin care?

    1.Use calamine lotion for pruritus
    2.Keep skin lubricated with lotion
    3.Apply warm soaks to inflamed areas
    4.Take frequent baths to remove scaly lesions

    2.Keep skin lubricated with lotion

    When assessing the oral cavity of a newly admitted client with acquired immunodeficiency syndrome (AIDS), the nurse identifies areas of white plaque on the client's tongue and palate. What is the nurse's initial response?

    1.Scrape an area of one of the lesions and send the specimen for a biopsy.
    2.Instruct the client to perform meticulous oral hygiene at least once daily.
    3.Document the presence of the lesions, describing their size, location, and color.
    4.Consider that these lesions are universally found in clients with AIDS and require no treatment.

    3.Document the presence of the lesions, describing their size, location, and color.

    A client is diagnosed with gastroenteritis. What does the nurse determine is the basic intention underlying the unique dietary management for this client?

    1.Provide optimal amounts of all important nutrients.
    2.Increase the amount of bulk and roughage in the diet.
    3.Eliminate chemical, mechanical, and thermal irritation.
    4.Promote psychological support by offering a wide variety of foods

    3.Eliminate chemical, mechanical, and thermal irritation.

    The health care provider prescribes peak and trough levels of an antibiotic for a client who is receiving the medication intravenous piggyback (IVPB). For peak levels the nurse should have the laboratory obtain a blood sample from the client:

    1.Between 30 and 60 minutes after the IVPB
    2.Halfway between two IVPB administrations
    3.Immediately before administering the IVPB
    4.Anytime it is convenient for the client and laboratory

    1.Between 30 and 60 minutes after the IVPB

    What is the incubation period for an infectious disease?

    1.The stage when acute symptoms of infection disappear
    2.The length of time a patient manifests signs and symptoms
    3.The interval between entrance of pathogen into body and appearance of first symptoms
    4.The interval from onset of nonspecific signs and symptoms to more specific signs and symptoms

    3.The interval between entrance of pathogen into body and appearance of first symptoms

    A client arrives at the clinic after being bitten by a raccoon in an area in the woods where rabies is endemic. When considering the client's needs, the nurse recalls that rabies is a:

    1.Bacterial septicemia resulting in convulsions and a morbid fear of water
    2.Viral infection characterized by convulsions and difficulty swallowing
    3.Parasitic infestation characterized by encephalopathy and opisthotonos
    4.Catalyst for an autoimmune response that results in a maculopapular rash and fever

    2.Viral infection characterized by convulsions and difficulty swallowing

    The nurse explains to a client that a positive diagnosis for human immunodeficiency virus (HIV) infection is made based on:

    1.Positive enzyme-linked immunosorbent assay (ELISA) and Western blot tests
    2.Performance of high-risk sexual behaviors
    3.Evidence of extreme weight loss and high fever
    4.Identification of an associated opportunistic infection

    1.Positive enzyme-linked immunosorbent assay (ELISA) and Western blot tests

    When taking the blood pressure of a client who has acquired immunodeficiency syndrome (AIDS), the nurse must:

    1.Don clean gloves
    2.Use barrier techniques
    3.Put on a mask and gown
    4.Wash the hands thoroughly

    4.Wash the hands thoroughly

    A client presents to the emergency department with a fever, headache, loss of appetite, and malaise. The nurse identifies raised red bumps on the client's arms and legs. A diagnosis of chickenpox is made. The client should be placed in a private room with what kind of precautions?

    1.Contact precautions
    2.Droplet precautions
    3.Airborne precautions
    4.No additional precautions other than standard precautions

    3.Airborne precautions

    A client in the emergency department states, "I was bitten by a raccoon while I was fixing a water pipe in the crawl space of my basement." Which is the most effective first-aid treatment for the nurse to use for this client?

    1.Administering an antivenin
    2.Maintaining a pressure dressing
    3.Cleansing the wound with soap and water
    4.Applying a tourniquet proximal to the wound

    3.Cleansing the wound with soap and water

    A nurse is caring for a client with a diagnosis of acute salpingitis. Which condition most commonly causing inflammation of the fallopian tubes should the nurse include when planning a teaching program for this client?

    1.Syphilis
    2.Gonorrhea
    3.Hydatidiform mole
    4.Spontaneous abortion

    2.Gonorrhea

    What criteria should the nurse consider when determining if an infection should be categorized as a health care-associated infection?

    1.Originated primarily from an exogenous source.
    2.Is associated with a drug resistant microorganism.
    3.Occurred in conjunction with treatment for an illness.
    4.Still has the infection despite completing the prescribed therapy

    3.Occurred in conjunction with treatment for an illness

    A nurse is planning to provide discharge teaching to the family of a client with acquired immunodeficiency syndrome (AIDS). Which statement should the nurse include in the teaching plan?

    1."Wash used dishes in hot, soapy water."
    2."Let dishes soak in hot water for 24 hours before washing."
    3."You should boil the client's dishes for 30 minutes after use."
    4."Have the client eat from paper plates so they can be discarded."

    1."Wash used dishes in hot, soapy water."

    Which disease is caused by protozoa?

    1.Leprosy
    2.Malaria
    3.Oral thrush
    4.Chickenpox

    2.Malaria

    A nurse is caring for a client with a diagnosis of acquired immunodeficiency syndrome (AIDS). The IV infiltrates and needs to be restarted. What is necessary to protect the nurse when restarting the IV? (Select all that apply.)

    1.Mask
    2.Gown
    3.Gloves
    4.Face shield
    5.Hand hygiene

    3.Gloves
    5.Hand hygiene

    Which prescribed medication should the nurse expect to administer to a female client who exhibits the genital lesions presented in the illustration?
    (HERPES GENITALIS)

    1.Zidovudine (Retrovir)
    2.Metronidazole (Flagyl)
    3.Ceftriaxone (Rocephin)
    4.Acyclovir sodium (Zovirax)

    4.Acyclovir sodium (Zovirax)

    A nurse observes that an unlicensed assistive personnel (UAP) did not use a bag impervious to liquid for contaminated linen from a client who is on contact precautions. The nurse's best way to handle this situation is to:

    1.Place the linen in an appropriate bag
    2.Write an incident report about the situation
    3.Review transmission-based precautions with the UAP
    4.Place an anecdotal summary of the behavior in the UAP's personnel record

    3.Review transmission-based precautions with the UAP

    A client developed acute herpes zoster and was treated with antiviral medication within 72 hours of the appearance of the rash. The client is reporting persistent pain one week later. What does the nurse identify as the cause of the post therapeutic neuralgia?

    1.Damage to the nerves
    2.Untreated major depression
    3.Scarring in the area of the rash
    4.Continued presence of the skin rash

    1.Damage to the nerves

    A client is concerned about contracting malaria while visiting relatives in Southeast Asia. What should the nurse teach the client to avoid to best prevent malaria?

    1.Mosquito bites
    2.Untreated water
    3.Undercooked food
    4.Overpopulated areas

    1.Mosquito bites

    A client is diagnosed with herpes genitalis. What should the nurse do to prevent cross-contamination?

    1.Institute droplet precautions.
    2.Arrange transfer to a private room.
    3.Wear a gown and gloves when giving direct care.
    4.Close the door and wear a mask when in the room.

    3.Wear a gown and gloves when giving direct care

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