Nokea
A client is undergoing preparation for extensive colorectal surgery. Which of the following oral antibiotics should be administered to suppress normal flora in the GI tract?
- A. Kanamycin
- B. Gentamicin
- C. Neomycin
- D. Tobramycin
Correct Answer: C
Rationale: The correct answer is C: Neomycin. Neomycin, an aminoglycoside antibiotic, is administered orally before GI surgery to eliminate the normal flora in the large intestine. This helps reduce the risk of postoperative infections by decreasing the bacterial load in the gut. Choices A, B, and D (Kanamycin, Gentamicin, Tobramycin) are not typically used to suppress normal flora in the GI tract before colorectal surgery.
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A 56-year-old man with chronic pain injects himself with morphine, which he obtained from a friend who is an emergency department nurse. He is found dead in his apartment by the police. What is the most likely cause of death?
- A. Congestive heart failure
- B. Hepatitis
- C. Respiratory depression
- D. Pulmonary edema
Correct Answer: C
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.
The following are first-line drugs for hypertension in diabetics with proteinuria:
- A. Lisinopril
- B. Losartan
- C. Amlodipine
- D. Hydrochlorothiazide
Correct Answer: A
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.
A client is starting a new prescription for enalapril. Which of the following instructions should the nurse include?
- A. Take the medication with food.
- B. Rise slowly from a sitting position.
- C. Avoid salt substitutes.
- D. Avoid exposure to sunlight.
Correct Answer: C
Rationale: The correct instruction for a client starting enalapril is to avoid salt substitutes. Salt substitutes may contain potassium, which could lead to elevated potassium levels when combined with enalapril, increasing the risk of hyperkalemia. Choices A, B, and D are incorrect because there is no specific need to take enalapril with food, rise slowly from a sitting position, or avoid exposure to sunlight when taking this medication.
A client is starting a new prescription for verapamil. Which of the following instructions should be included?
- A. Take the medication with a full glass of water.
- B. Avoid grapefruit juice.
- C. Monitor blood pressure regularly.
- D. Monitor heart rate daily.
Correct Answer: B
Rationale: Clients prescribed verapamil should be advised to avoid grapefruit juice as it can potentiate the drug's effects, leading to adverse reactions. Grapefruit juice can inhibit the metabolism of verapamil, resulting in higher blood levels of the medication and an increased risk of side effects. Instructions such as taking the medication with a full glass of water (Choice A) are not specific to verapamil and are generally recommended. While monitoring blood pressure regularly (Choice C) is important for clients on antihypertensive medications, it is not a direct concern related to verapamil. Monitoring heart rate daily (Choice D) is not a primary consideration when starting verapamil, as it is more commonly used for its effects on blood pressure and arrhythmias rather than heart rate.
A healthcare professional is obtaining a medication history from a client who is to receive Imipenem-cilastatin IV to treat an infection. Which of the following medications the client also receives puts them at risk for a medication interaction?
- A. Regular insulin
- B. Furosemide
- C. Valproic acid
- D. Ferrous sulfate
Correct Answer: C
Rationale: The correct answer is C, Valproic acid. Imipenem-cilastatin decreases the blood levels of valproic acid, an antiseizure medication, which can lead to increased seizure activity. Monitoring and adjusting the dosage of valproic acid may be necessary when co-administered with Imipenem-cilastatin to prevent adverse effects. Choices A, B, and D do not typically interact significantly with Imipenem-cilastatin and are not associated with a high risk of adverse interactions in this scenario.