Patient Data

The healthcare provider is considering medications for the client to treat juvenile idiopathic arthritis.

Choose the most likely options for the information missing from the statement(s) by selecting from the lists of options provided.

When administering nonsteroidal anti-inflammatory drugs (NSAIDs), the nurse should educate the client to
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and
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and prolonged use
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.

Answer and Explanation

The Correct Answer is {"dropdown-group-1":"B","dropdown-group-2":"A","dropdown-group-3":"A"}

Rationale

• Have periodic liver/renal functioning laboratory testing due to potential for nephrotoxicity: NSAIDs can affect renal function, particularly with prolonged use, and may also impact liver enzymes. Educating the client and caregivers about the need for regular lab monitoring helps detect early nephrotoxicity or hepatotoxicity. This is especially important in a pediatric patient with juvenile idiopathic arthritis who may require long-term therapy.

• Avoid exposure to sunlight due to photosensitivity: NSAIDs are not associated with photosensitivity. While some medications can increase sun sensitivity, this is not a primary concern for NSAID therapy in JIA. Sun protection is not routinely emphasized for NSAID administration.

• Monitor blood glucose levels daily: NSAIDs do not significantly affect blood glucose levels. Daily glucose monitoring is unnecessary unless the client has another condition, such as diabetes.

• Take with grapefruit juice to improve absorption: Grapefruit juice can interfere with the metabolism of some medications, but it is not recommended with NSAIDs. It does not improve absorption and could potentially cause interactions with other medications.

• Avoid dairy products while on medication: NSAIDs can be taken with food, including dairy, to minimize GI upset. Avoiding dairy is not necessary for efficacy or safety and is therefore nonessential for education.

• Folic acid supplements can reduce incidence of oral ulcers: Some NSAIDs and concurrent medications (like methotrexate, often used in JIA) can contribute to oral ulceration. Folic acid supplementation helps prevent these side effects and supports overall cellular health. Educating the client about this supplement promotes comfort and adherence to the treatment regimen.

• Can have gastrointestinal side effects: NSAIDs are well known for causing gastrointestinal irritation, including nausea, abdominal pain, and ulcer formation. The client and caregiver should be informed to recognize early symptoms and take NSAIDs with food to reduce GI irritation. Awareness helps prevent serious complications and supports safe long-term use.

• May cause skin rash or itching / Can cause hair loss: Although NSAIDs can rarely cause allergic reactions, these are uncommon. Hair loss is not associated with NSAID therapy. These effects are not primary concerns in routine patient education for pediatric NSAID administration.

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Free Nursing Study Resources

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

Explanation

Rationale:
A. Send wound drainage for culture and sensitivity: Obtaining a culture identifies MRSA as the causative organism and determines antibiotic susceptibility. This guides targeted antimicrobial therapy and reduces the risk of treatment failure. Accurate identification is essential for infection control and clinical management.

B. Explain the purpose of a low bacteria diet: A low bacteria (neutropenic) diet is reserved for clients with severe immunosuppression, such as those undergoing chemotherapy. Localized MRSA wound infections do not require dietary bacterial restriction. Nutrition should focus on adequate protein and calories for wound healing.

C. Use standard precautions and wear a mask: MRSA wound infections require standard precautions plus contact precautions. A mask is not routinely required unless there is risk of splashing or respiratory involvement. Gloves and gowns are the primary protective measures.

D. Institute contact precautions for staff and visitors: MRSA is transmitted via direct and indirect contact with contaminated surfaces or drainage. Contact precautions, including gloves and gowns, reduce transmission to healthcare workers and other clients. These precautions are essential in preventing hospital-acquired spread.

E. Monitor the client's white blood cell count (WBC): The WBC count helps assess the presence and progression of infection and the client’s response to treatment. Trends in WBC levels can indicate worsening infection or resolution. Ongoing monitoring supports timely clinical decision-making.

A. Advise the UAP to wear a standard face mask to obtain vital signs, and then get fitted for a filter mask before providing personal care. B. Before changing assignments, determine which staff members have fitted particulate filter masks. C. Instruct the UAP that a standard face mask is sufficient to be able to provide care for the assigned client. D. Send the UAP to be fitted for a particulate filter mask immediately to be able to provide care to this client.

Correct Answer is C

Explanation

Rationale:
A. Advise the UAP to wear a standard face mask to obtain vital signs, and then get fitted for a filter mask before providing personal care: Droplet precautions require a standard surgical mask for close contact, not a particulate filter mask. Requiring additional fitting creates unnecessary delay and reflects confusion between droplet and airborne precautions.

B. Before changing assignments, determine which staff members have fitted particulate filter masks: Staff fitted with particulate filter masks are required for airborne precautions such as tuberculosis or measles. Influenza is transmitted via respiratory droplets and does not require N95-level protection. Reassigning based on mask fit is not clinically indicated.

C. Instruct the UAP that a standard face mask is sufficient to be able to provide care for the assigned client: Droplet precautions require the use of a standard surgical mask when within close proximity to the client. Influenza is spread through large respiratory droplets, which are effectively blocked by a standard mask.

D. Send the UAP to be fitted for a particulate filter mask immediately to be able to provide care to this client: Particulate filter masks are reserved for airborne pathogens and are not required for droplet-transmitted infections. Sending the UAP for fitting delays care and reflects incorrect application of isolation protocols.

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Naxlex Comprehensive Predictor Exams

A client with foul smelling drainage from an incision on the upper left arm is admitted with a suspected methicillin-resistant Staphylococcus aureus (MRSA). Which nursing intervention(s) should the nurse include in the plan of care (POC)? Select all that apply.

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

Explanation

An unlicensed assistive personnel (UAP) is assigned to a client with flu-like symptoms who has been placed on droplet precautions. The UAP requests a change in assignment because the UAP has not yet been fitted for a particulate filter mask. Which action should the nurse take?

Correct Answer is C

Explanation

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