A nurse on a telemetry unit receives change-of-shift report on four clients. Which of the following clients should the nurse assess first?

A client with myasthenia gravis who has bilateral ptosis and a positive edrophonium (Tensilon) test.

A client with Bell's palsy who has an order for prednisone and acyclovir.

A client with Parkinson's disease who has hypokinetic dysarthria and a lack of facial expressions.

A client with multiple sclerosis who has bladder flaccidity and is retaining urine.

Answer and Explanation

The Correct Answer is A

A.   A client with myasthenia gravis who has bilateral ptosis and a positive edrophonium test is likely experiencing a myasthenic crisis, which is a life-threatening condition that requires immediate attention. This client would be the priority because they may require rapid intervention to maintain airway and breathing.
B.   Bell's palsy is characterized by sudden onset of facial paralysis due to inflammation of the facial nerve. While Bell's palsy can be distressing for the client, it does not typically require urgent intervention unless there are complications such as corneal abrasion due to inability to close the eye.
C.   Parkinson's disease is a chronic neurodegenerative disorder characterized by motor symptoms such as tremors, rigidity, bradykinesia (slowness of movement), and postural instability. While this client requires ongoing assessment and care, the symptoms described do not typically indicate an acute or urgent need for intervention.
D.   A client with multiple sclerosis who has bladder flaccidity and is retaining urine needs assessment and intervention to prevent complications such as urinary tract infections or renal damage. However, this is not as immediately life-threatening as a myasthenic crisis.

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Correct Answer is ["A","D"]

Explanation

A. Allowing the affected skin to be exposed to air can help in promoting healing and preventing further irritation. However, it's essential to ensure the environment is clean and that the area is protected from friction and contamination.
B. Ice packs should be avoided as they can cause further irritation to the radiated skin, and alcohol- based lotions can be drying and may exacerbate skin reactions.

C. Alcohol-based lotions can be drying and irritating to sensitive, radiation-treated skin. It's preferable to use gentle, non-alcohol-based moisturizers or barrier creams that are specifically designed for sensitive skin. These can help soothe the skin and prevent excessive dryness and irritation.
D. Aloe vera gel is known for its soothing and moisturizing properties, which can help alleviate discomfort and promote healing of radiation-damaged skin. It is gentle and generally well-tolerated by most individuals.
E. Betadine (povidone-iodine) can be too harsh for radiation-damaged skin and may further irritate the area. Gentle cleansing with mild soap and water is recommended to keep the area clean and minimize the risk of infection.

A. To control the heart rate and reduce the oxygen demand of the heart. B. To prevent platelet aggregation in order to prevent thrombus formation. C. To reduce LDL cholesterol to prevent the formation of additional plaques. D. To relieve acute episodes of angina when they occur.

Correct Answer is C

Explanation

A. This function is typically managed by medications such as beta-blockers or calcium channel blockers, which help reduce heart rate and myocardial oxygen demand. Rosuvastatin does not directly affect heart rate or myocardial oxygen demand.
B. Medications like aspirin or other antiplatelet agents are used to inhibit platelet aggregation and reduce the risk of thrombus formation. Rosuvastatin is not primarily indicated for this purpose.
C. This is the correct rationale for prescribing rosuvastatin in a client with chronic stable angina. High LDL cholesterol levels contribute to the development and progression of atherosclerosis, which narrows coronary arteries and leads to angina. By lowering LDL cholesterol levels, rosuvastatin helps slow down the progression of atherosclerosis and reduces the risk of cardiovascular events, including angina.
D. Acute episodes of angina are typically managed with short-acting nitrates or other medications that dilate coronary arteries to improve blood flow to the heart muscle. Rosuvastatin does not provide immediate relief of angina symptoms.

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A nurse on a telemetry unit receives change-of-shift report on four clients. Which of the following clients should the nurse assess first?

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Naxlex Comprehensive Predictor Exams

A client who is undergoing external beam radiation for prostate cancer has developed desquamation of the skin in the treatment area. Which of the following statements should the nurse plan to include for this patient? (Select all that apply.)

Correct Answer is ["A","D"]

Explanation

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Correct Answer is C

Explanation

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