A nurse in the provider's office is caring for a child who has a history of tonic-clonic seizure disorder. Three months ago, the neurologist changed the child's antiepileptic medications to include Phenytoin due to increasing number of seizures per guardian. The child has a 1-year history of mild exercise-induced asthma for which they were prescribed a rescue inhaler of albuterol prn.
The client is at risk for developing
The Correct Answer is {"dropdown-group-1":"C","dropdown-group-2":"C"}
Choice A reason: Gingival hyperplasia is a condition where the gums become enlarged and inflamed. It is a common side effect of Phenytoin, a medication used to treat seizures. The nurse should educate the client and the guardian about the importance of oral hygiene and regular dental check-ups to prevent or manage this condition.
Choice B reason: Hypoglycemia is a condition where the blood glucose level becomes too low. It is not a common side effect of albuterol, a medication used to treat asthma. Albuterol may cause tremors, tachycardia, or nervousness, but not hypoglycemia.
Choice C reason: Status epilepticus is a condition where seizures occur repeatedly without recovery. It is a medical emergency that requires immediate treatment. It may be triggered by exercise, but not necessarily. The nurse should ensure that the client has their seizure medication and rescue inhaler available at all times and knows how to use them.
Choice D reason: Bronchospasm is a condition where the airways become narrowed and obstructed. It is a common symptom of asthma, but not a side effect of Phenytoin. Phenytoin may cause other adverse effects, such as rash, nausea, or drowsiness, but not bronchospasm.
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Naxlex Comprehensive Predictor Exams
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Correct Answer is B
Explanation
Choice A reason: Watching a video game in the playroom is not a good activity for a child who requires airborne precautions, as it may expose the child and other children to the risk of infection. Airborne precautions are used for patients who have diseases that are transmitted by small droplets that can remain suspended in the air and travel over long distances, such as tuberculosis, chickenpox, or measles. The child should stay in a private room with negative air pressure, high-efficiency particulate air (HEPA) filtration, and respiratory protection for health care workers and visitors.
Choice B reason: Putting a large-piece puzzle together is a good activity for a child who requires airborne precautions, as it can be done in the child's room and does not involve close contact with others. It is also developmentally appropriate for a 4-year-old child, as it helps to develop fine motor skills, cognitive skills, and problem-solving skills. The nurse should provide the child with a variety of puzzles that are colorful, fun, and challenging, but not frustrating.
Choice C reason: Constructing a model airplane is not a good activity for a child who requires airborne precautions, as it may involve small pieces that can be easily lost, swallowed, or inhaled. It may also be too difficult or complex for a 4-year-old child, who may not have the attention span, dexterity, or patience to complete the task. The nurse should choose activities that are safe, simple, and suitable for the child's age and abilities.
Choice D reason: Pulling a wagon with toys in the hallway is not a good activity for a child who requires airborne precautions, as it may expose the child and other people to the risk of infection. The child should not leave the room unless it is necessary for diagnostic or therapeutic procedures. If the child has to leave the room, the nurse should ensure that the child wears a mask and follows the infection control guidelines. The nurse should also minimize the movement and transport of the child.
Correct Answer is D
Explanation
Choice A reason: Weight loss is not a typical finding in a toddler who has heart failure. Weight gain due to fluid retention is more likely to occur. The nurse should monitor the toddler's weight and fluid intake and output regularly.
Choice B reason: Bradycardia is not a typical finding in a toddler who has heart failure. Tachycardia due to increased cardiac workload is more likely to occur. The nurse should monitor the toddler's heart rate and rhythm frequently.
Choice C reason: Increased urine output is not a typical finding in a toddler who has heart failure. Decreased urine output due to poor renal perfusion is more likely to occur. The nurse should monitor the toddler's urine specific gravity and electrolytes periodically.
Choice D reason: Orthopnea is a typical finding in a toddler who has heart failure. Orthopnea is the difficulty of breathing when lying flat. The nurse should elevate the toddler's head and chest to facilitate breathing and oxygenation.
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