A client with tuberculosis returns to the clinic for daily antibiotic injections for a urinary infection. The client has been taking antitubercular medications for 10 weeks and reports ringing in the ears. Which prescribed medication should the practical nurse (PN) report to the healthcare provider?

Isoniazid 300 mg by mouth (PO) daily.

Gentamicin 160 mg intramuscular (IM) daily.

Pyridoxine with a B complex multivitamin by mouth (PO) daily.

Rifampin 600 mg by mouth (PO) daily.

Answer and Explanation

The Correct Answer is B

A. Isoniazid can cause side effects like peripheral neuropathy, but ringing in the ears is not a common symptom of this medication.
B. Gentamicin can cause ototoxicity, which includes symptoms such as ringing in the ears (tinnitus). This side effect is significant and should be reported to the healthcare provider for further evaluation.
C. Pyridoxine is used to prevent neuropathy caused by isoniazid and does not cause ringing in the ears.
D. Rifampin is an antitubercular medication but is not commonly associated with tinnitus as a side effect. The immediate concern with ringing in the ears is related to gentamicin.

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Correct Answer is A

Explanation

A. The submandibular lymph nodes are located beneath the lower jaw, in the area where the jawbone meets the neck. This is the correct location to palpate for enlargement of these lymph nodes.
B. The temporal bone is located on the side of the head, not relevant to the location of the submandibular lymph nodes. Palpation for these nodes occurs beneath the lower jaw, not near the temporal bone.
C. Lateral to the trachea refers to the location of other lymph nodes such as the anterior cervical or supraclavicular nodes, not the submandibular nodes. Submandibular nodes are specifically beneath the jaw.
D. Above the upper jaw does not correspond to the location of the submandibular lymph nodes. These nodes are palpated beneath the lower jaw, making this option incorrect.

A. Acquire coping skills. B. Conserve energy. C. Adapt self-care skills. D. Improve body image.

Correct Answer is B

Explanation

A. Acquiring coping skills is important, but the immediate focus for discharge planning is on practical goals related to managing daily activities and maintaining independence rather than on long-term psychological coping.
B. Conserve energy is the most important goal for a client with rheumatoid arthritis preparing for discharge. Managing energy effectively helps clients cope with fatigue and pain, which are common challenges in daily life with rheumatoid arthritis.
C. Adapting self-care skills is also important but is a broader goal that includes conserving energy as a component. Effective energy management is a key aspect of self-care for clients with rheumatoid arthritis.
D. Improving body image is a valid goal but is not the most urgent concern for discharge planning. The primary focus should be on practical aspects of managing rheumatoid arthritis in daily life.

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Naxlex Comprehensive Predictor Exams

Which location should the practical nurse (PN) palpate to determine if a client's submandibular lymph nodes are enlarged?

Correct Answer is A

Explanation

The practical nurse (PN) is assigned to provide care for a client with rheumatoid arthritis who is preparing for discharge. While planning the client's care, the PN should identify which client goal as the most important?

Correct Answer is B

Explanation

The practical nurse (PN) positions a temporal artery scanner as seen in the picture. Before obtaining a temperature measurement, which assessment of the skin should the PN complete?

The practical nurse (PN) is preparing to transfer an unresponsive client from the bed to a stretcher. Which client data is most important for the PN to obtain before beginning the transfer?

Exhibits The practical nurse (PN) re-educates the client on methicillin-resistant Staphylococcus aureus (MRSA). Click to indicate whether the client's statement(s) indicate understanding or no understanding. Each row must have one option selected.

The practical nurse (PN) is reviewing home care instructions with the mother of a young girl with a urinary tract infection (UTI). Which information reported by the mother demonstrates understanding of home care for the child?

An older adult client who had a colon resection 8 days ago is straining at stool. The practical nurse (PN) observes sudden spillage of serosanguinous drainage from the client's wound followed by appearance of bowel on the skin. Which complication has occurred?

The practical nurse (PN) is caring for a client whose urine drug screen is positive for cocaine. Which behavior should the PN document as evidence of cocaine withdrawal?

A 3-year-old male is being discharged after surgical correction of cryptorchidism. Which postoperative instruction is most important for the practical nurse (PN) to re-emphasize to the parents about the child's activities at home?