Nokea
A nurse is teaching a client who has angina a new prescription for sublingual nitroglycerin tablets. Which of the following instructions should the nurse include in the teaching?
- A. Discard any tablets you do not use every 6 months.
- B. Take one tablet each morning 30 minutes prior to eating.
- C. Keep the tablets at room temperature in their original glass bottle.
- D. Place the tablet between your cheek and gum to dissolve.
Correct Answer: C
Rationale: The correct answer is C: Keep the tablets at room temperature in their original glass bottle. Nitroglycerin tablets are sensitive to light, moisture, and heat. Storing them in their original glass bottle at room temperature helps maintain their potency. Discarding unused tablets every 6 months (choice A) is not necessary as long as they are stored properly. Taking a tablet each morning (choice B) is not recommended as nitroglycerin is usually taken as needed for angina attacks. Placing the tablet between cheek and gum (choice D) is not the correct administration route for sublingual nitroglycerin, as it should be placed under the tongue for rapid absorption.
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A nurse is caring for a client who is in shock and is receiving an infusion of albumin. Which of the following findings should the nurse expect?
- A. Oxygen saturation 96%
- B. PaCO2 30 mm Hg
- C. Increase in BP
- D. Decrease in protein
Correct Answer: C
Rationale: The correct answer is C: Increase in BP. Albumin is a colloid solution that helps increase blood volume and subsequently improves blood pressure in shock patients. Increasing blood volume leads to an increase in blood pressure. Option A is incorrect because oxygen saturation is not directly affected by albumin infusion. Option B is incorrect because a low PaCO2 level is not a direct effect of albumin infusion. Option D is incorrect because albumin is a protein and its infusion would not lead to a decrease in protein levels.
A home health nurse is visiting a client who has heart failure and a prescription for furosemide. The nurse identifies that the client has gained 2.5 kg (5 lb.) since the last visit 2 days ago. Which of the following actions should the nurse take first?
- A. Encourage the client to dangle the legs while sitting in a chair
- B. Teach the client about foods low in sodium
- C. Determine medication adherence by the client
- D. Notify the provider of the client's weight gain
Correct Answer: D
Rationale: The correct answer is D: Notify the provider of the client's weight gain. This is the first action the nurse should take because sudden weight gain in a client with heart failure could indicate fluid retention, which may worsen the client's condition. By notifying the provider, the nurse can ensure timely intervention to adjust the medication or treatment plan. Encouraging leg dangling (A) may help with circulation but does not address the immediate concern of weight gain. Teaching about low-sodium foods (B) is important for long-term management but not the priority at this moment. Determining medication adherence (C) is important but should come after addressing the immediate weight gain issue.
A nurse is reviewing the list of current medications for a client who is to start a prescription for carbamazepine. The nurse should identify that which of the following medications interacts with carbamazepine?
- A. Nicotine transdermal system
- B. Diphenhydramine
- C. Estrogen-progestin combination
- D. Beclomethasone
Correct Answer: C
Rationale: The correct answer is C: Estrogen-progestin combination. Carbamazepine can decrease the effectiveness of estrogen-containing medications, including estrogen-progestin combinations, by increasing their metabolism. This can lead to reduced contraceptive efficacy and breakthrough bleeding.
Nicotine transdermal system (choice A) does not have a significant interaction with carbamazepine. Diphenhydramine (choice B) is an antihistamine and does not interact with carbamazepine. Beclomethasone (choice D) is a corticosteroid and does not have a significant interaction with carbamazepine.
A nurse is assessing a client who has hypermagnesemia. Which of the following medications should the nurse prepare to administer?
- A. Protamine sulfate
- B. Acetylcysteine
- C. Calcium gluconate
- D. Flumazenil
Correct Answer: C
Rationale: The correct answer is C: Calcium gluconate. In hypermagnesemia, there is an excess of magnesium in the blood, leading to muscle weakness, cardiac arrhythmias, and respiratory depression. Calcium gluconate is the antidote for hypermagnesemia as it works by antagonizing the effects of magnesium. By administering calcium gluconate, the nurse can help reverse the symptoms associated with hypermagnesemia and restore normal calcium levels in the body. Protamine sulfate (Choice A) is used to reverse the effects of heparin, acetylcysteine (Choice B) is used as an antidote for acetaminophen overdose, and flumazenil (Choice D) is used to reverse the effects of benzodiazepines. These medications are not indicated for hypermagnesemia.
Which of the following statements should the nurse include when teaching the client about the prescribed medication?
- A. The medication can cause nausea, so take with a meal.
- B. You can experience vivid nightmares.
- C. You may notice your urine becomes lighter in color.
- D. Consumption of a high protein meal can reduce the effectiveness of the medication.
- E. You may initially notice an increase in involuntary movements.
Correct Answer: A
Rationale: The correct answer is A because taking the medication with a meal can help reduce nausea. This statement is important to ensure client compliance and improve medication tolerance. Choice B is incorrect as vivid nightmares are not a common side effect of the medication. Choice C is incorrect as urine color change is not relevant to this medication. Choice D is incorrect as high protein meals do not affect medication effectiveness. Choice E is incorrect as an increase in involuntary movements is not expected with this medication.