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A nurse is caring for a client who is starting to take aspirin 81 mg daily. Which of the following findings should the nurse identify as a risk factor for the client's development of an aspirin-induced ulcer?
- A. The client has a history of alcohol use disorder but is currently sober
- B. The client recently had a norovirus infection
- C. The client smokes one pack of cigarette per day
- D. The client has a history of rheumatoid arthritis
Correct Answer: C
Rationale: The correct answer is C: The client smokes one pack of cigarette per day. Smoking is a known risk factor for the development of ulcers, and when combined with aspirin use, it further increases the risk. Smoking decreases the production of prostaglandins in the stomach lining, which can lead to increased susceptibility to ulcers. Choices A, B, and D are not directly related to an increased risk of aspirin-induced ulcers. Choice A indicates a previous history of alcohol use disorder, which may have implications for liver health but not directly related to ulcers caused by aspirin. Choice B mentions a recent norovirus infection, which is not a risk factor for aspirin-induced ulcers. Choice D states a history of rheumatoid arthritis, which may necessitate the use of aspirin but does not inherently increase the risk of ulcers when combined with it.
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A nurse is providing teaching to a client who has chronic rheumatoid arthritis and a new prescription for hydroxychloroquine. The nurse should instruct the client to obtain which of the following diagnostic studies routinely?
- A. Eye examination
- B. Chest -ray
- C. Pancreatic enzyme levels
- D. Urinalysis screening
Correct Answer: A
Rationale: The correct answer is A: Eye examination. Hydroxychloroquine can cause retinal toxicity, so regular eye exams are essential to monitor for any ocular changes. This is crucial in preventing irreversible vision damage. Choices B, C, and D are not routinely necessary for monitoring hydroxychloroquine therapy and are not directly related to its potential side effects. A chest x-ray is not typically indicated unless specific symptoms or concerns arise. Pancreatic enzyme levels and urinalysis are not directly impacted by hydroxychloroquine use. Therefore, the most appropriate diagnostic study for this client would be an eye examination to monitor for potential retinal toxicity.
A nurse is caring for a client who is receiving diazepam as sedation for an endoscopy, Which of the following antidotes should the nurse have on hand during the procedure?
- A. Naloxone
- B. Atropine
- C. Flumazenil
- D. Neostigmine
Correct Answer: C
Rationale: The correct answer is C: Flumazenil. Flumazenil is the antidote for benzodiazepines like diazepam, used for sedation. It works by competitively inhibiting benzodiazepine binding, reversing sedative effects. Naloxone (A) is for opioid overdose, Atropine (B) for bradycardia, and Neostigmine (D) for reversing neuromuscular blockade. No other choices provided. In summary, Flumazenil is the appropriate antidote for benzodiazepine overdose, making it the correct choice in this scenario.
A nurse is providing teaching to a client who has a history of diabetes mellitus and a new prescription for hydrochlorothiazide to treat uncontrolled hypertension. Which of the following information should the nurse include in the teaching?
- A. Blood glucose monitoring is likely to be inaccurate while taking hydrochlorothiazide
- B. You might need to decrease your insulin dosage while taking hydrochlorothiazide.
- C. Hydrochlorothiazide therapy can elevate blood glucose levels in clients who have diabetes
- D. Reducing sodium in your die whim taking your control your blood glucose.
Correct Answer: C
Rationale: The correct answer is C: Hydrochlorothiazide therapy can elevate blood glucose levels in clients who have diabetes. Hydrochlorothiazide is a diuretic that can lead to increased blood glucose levels, particularly in individuals with diabetes. This is important for the nurse to include in the teaching to ensure the client is aware of potential effects on their blood glucose levels.
A: Blood glucose monitoring is likely to be inaccurate while taking hydrochlorothiazide - This statement is incorrect as monitoring blood glucose levels is still important while taking hydrochlorothiazide.
B: You might need to decrease your insulin dosage while taking hydrochlorothiazide - This statement is incorrect as hydrochlorothiazide can elevate blood glucose levels, which may necessitate adjustments to insulin dosage.
D: Reducing sodium in your diet will help control your blood glucose - This statement is not directly related to the effects of hydrochlorothiazide on blood glucose levels.
In summary, choice C is the correct
A nurse is planning care for a client who has a new prescription to receive a continuous infusion of total parenteral nutrition (TPN) Which of the following interventions should the nurse implement?
- A. Change the TPN infusion tubing once every 3 days
- B. Check the client's blood glucose level regularly
- C. Insert the peripheral IV catheter for administration
- D. Monitor the client's weight every 3 days
Correct Answer: B
Rationale: The correct answer is B: Check the client's blood glucose level regularly. This is essential as TPN is a high-calorie, nutrient-dense solution that can increase the risk of hyperglycemia. Monitoring blood glucose levels helps the nurse assess the client's response to TPN and adjust the infusion rate accordingly to prevent complications.
Option A is incorrect because changing the TPN infusion tubing once every 3 days is not a priority in this situation. Option C is incorrect as TPN should be administered through a central venous catheter, not a peripheral IV catheter. Option D is incorrect as monitoring the client's weight every 3 days is not as crucial as monitoring blood glucose levels when on TPN.
A nurse is reviewing the medical record of a client who has a new prescription for verapamil. Which of the following findings in the client's medical record should the nurse identify as a contraindication for the administration of verapamil?
- A. History of asthma
- B. History of heart failure
- C. Systolic BP 110 mm Hg
- D. Blood creatinine 1.0 mg/dl
Correct Answer: B
Rationale: The correct answer is B: History of heart failure. Verapamil is a calcium channel blocker that can worsen heart failure by causing negative inotropic effects, leading to decreased contractility of the heart muscle. It can also cause peripheral vasodilation, potentially exacerbating heart failure symptoms. A history of heart failure is a contraindication for verapamil due to the risk of worsening the condition.
Incorrect choices:
A: History of asthma - Asthma is not a contraindication for verapamil as it does not directly affect respiratory function.
C: Systolic BP 110 mm Hg - While low blood pressure may be a concern with verapamil, a systolic blood pressure of 110 mm Hg alone is not a contraindication.
D: Blood creatinine 1.0 mg/dl - A creatinine level of 1.0 mg/dl is within the normal range and does not impact the use of verapamil.