An 18-year-old client is diagnosed with mononucleosis and manifests left upper quadrant tenderness and an enlarged spleen. Which is the most important teaching that the practical nurse (PN) should offer this client?
Gargle with warm salt water three times every day and PRN.
Avoid exposing the older client who may develop complications.
Stay at home and isolate from others for two weeks.
Use stool softeners to prevent a valsalva maneuver.
The Correct Answer is D
A. Gargle with warm salt water: Helps sore throat but not most urgent.
B. Avoid exposing older client to complications: Not related to spleen risk.
C. Stay home and isolate for two weeks: Good infection control but not most critical.
D. Use stool softeners to prevent Valsalva maneuver: Valsalva increases intra-abdominal pressure and risk of splenic rupture.
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Related Questions
Correct Answer is D
Explanation
A. Ask the caregiver about the toddler's hospital experience:
While this provides background, it doesn’t directly involve the caregiver in the assessment process.
B. Distract the toddler through play:
Helpful to reduce anxiety but does not promote family involvement.
C. Explain to the toddler what will happen:
Toddlers have limited understanding; caregiver participation is more effective.
D. Request for the caregiver to assist during the toddler's assessment:
Family-centered care involves active caregiver participation, helping the child feel secure.
Correct Answer is A
Explanation
A. Obtain a specimen of urethral drainage for culture:
Symptoms suggest possible gonorrhea or chlamydia; culture needed for diagnosis and treatment guidance.
B. Identify all sexual partners in the last four days:
Partner notification is important but follows confirmed diagnosis.
C. Observe the perineal area for a chancroid-like lesion:
Chancroid presents differently; symptoms point to urethritis.
D. Assess for perineal itching, erythema, and excoriation:
These are signs of fungal infection or dermatitis, not primary concern here.
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