Nokea
The clinic nurse is seeing a client who is taking duloxetine hydrochloride. When updating the client's medical history, for which condition mentioned by the client would the nurse notify the health care provider?
- A. recent worsening of insomnia
- B. unplanned weight loss of 6 pounds
- C. uncontrolled narrow-angle glaucoma
- D. removal of a benign skin cancer on the leg
Correct Answer: C
Rationale: Duloxetine, an SNRI, is contraindicated in uncontrolled narrow-angle glaucoma due to risk of mydriasis and increased intraocular pressure.
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The nurse is caring for a client diagnosed with tuberculosis. The physician plans to treat the client with a first-line medication. Which medication should the nurse prepare to administer?
- A. rifampin
- B. ciprofloxacin
- C. levofloxacin
- D. streptomycin
Correct Answer: A
Rationale: Rifampin is a first-line tuberculosis medication. Ciprofloxacin (B) and levofloxacin (C) are not first-line, and streptomycin (D) is a second-line injectable.
The nurse is teaching a client about alendronate sodium (Fosamax). Which statement by the client indicates a need for further teaching?
- A. I should take this with a meal.
- B. I will call my doctor if I develop a fever.
- C. I should not lie down for at least 30 minutes.
- D. Dairy products reduce the absorption of this medicine.
Correct Answer: A
Rationale: Alendronate should be taken on an empty stomach to maximize absorption, not with a meal, indicating a need for further teaching.
A client is ordered to receive 1,000 ml of D5W over 6 hours. The infusion set administers 10 gtt/mL. At what rate (gtt/min) should the nurse set the flow?
- A. 24 gtt/min
- B. 26 gtt/min
- C. 28 gtt/min
- D. 30 gtt/min
Correct Answer: C
Rationale: Calculation: (1,000 mL ÷ 6 hours) X (10 gtt/mL ÷ 60 min/hour) = 1,000 X 10 ÷ 360 = 27.78, rounded to 28 gtt/min.
The nurse is preparing to administer furosemide IM to a 6-month-old client with edema. Which location is the preferred injection site for this client?
- A. the gluteus medius
- B. the vastus lateralis
- C. the dorsogluteal site
- D. the ventrogluteal muscle
Correct Answer: B
Rationale: The vastus lateralis (B) is the preferred IM injection site in infants due to its muscle mass and safety. Gluteal sites (A, C, D) are avoided in young children due to underdeveloped muscles and sciatic nerve risk.