Thirty minutes after receiving meperidine, the client develops a temperature of 101°F and the skin is warm and flushed with a notable rash on the chest and back.

The nurse contacts the primary health care provider and begins to document on an incident report.

Which information should be included?

The client had an allergic reaction to the ordered meperidine.

The primary health care provider was notified because the client developed a rash after receiving an opioid analgesic.

The client’s skin was warm and flushed, and a rash was noted on the chest and back.

Thirty minutes after receiving meperidine, the temperature was 101°F (38.3°C).

Answer and Explanation

The Correct Answer is D

Choice A rationale

Stating that the client had an allergic reaction to the ordered meperidine is not objective and does not provide specific details about the client’s condition.

Choice B rationale

Notifying the primary health care provider because the client developed a rash after receiving an opioid analgesic is important, but it does not include all the necessary details about the client’s condition.

Choice C rationale

Documenting that the client’s skin was warm and flushed, and a rash was noted on the chest and back is important, but it does not include the timing of the reaction or the client’s temperature.

Choice D rationale

Documenting that thirty minutes after receiving meperidine, the temperature was 101°F (38.3°C), the client’s skin was warm and flushed, and a rash was noted on the chest and back provides a complete and objective account of the client’s condition and the timing of the reaction.

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Correct Answer is C

Explanation

Choice A rationale

Dysphagia, or difficulty swallowing, is not a common manifestation of acoustic neuroma. It is more commonly associated with conditions affecting the throat or esophagus.

Choice B rationale

Apraxia, a motor disorder caused by damage to the brain, is not typically associated with acoustic neuroma. It affects the ability to perform coordinated movements.

Choice C rationale

Vertigo, or a sensation of spinning, is a common manifestation of acoustic neuroma. The tumor affects the vestibular nerve, which is responsible for balance and spatial orientation.

Choice D rationale

Diplopia, or double vision, is not a common symptom of acoustic neuroma. It is more often associated with conditions affecting the muscles or nerves controlling eye movement.

A. Headaches and blurred vision. B. Tremors and weakness. C. Rash symptoms. D. Painful joints.

Correct Answer is C

Explanation

Choice A rationale

Headaches and blurred vision are not specific to stage I Lyme disease. These symptoms can occur in many other conditions and are not the primary indicators of early Lyme disease.

Choice B rationale

Tremors and weakness are not typical early signs of Lyme disease. These symptoms are more associated with neurological involvement, which occurs in later stages of the disease.

Choice C rationale

Rash symptoms, specifically erythema migrans (a bull’s-eye rash), are the hallmark of stage I Lyme disease. This rash appears at the site of the tick bite and is a key diagnostic feature.

Choice D rationale

Painful joints are more commonly seen in later stages of Lyme disease when the infection has spread and caused more systemic involvement.

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Thirty minutes after receiving meperidine, the client develops a temperature of 101°F and the skin is warm and flushed with a notable rash on the chest and back. The nurse contacts the primary health care provider and begins to document on an incident report. Which information should be included?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is assessing a client who has an acoustic neuroma. Which of the following client manifestations should the nurse expect?

Correct Answer is C

Explanation

A client calls the health care clinic and asks the nurse to describe the first signs of Lyme disease. The nurse informs the client to watch for which signs/symptoms of stage I Lyme disease?

Correct Answer is C

Explanation

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