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The nurse is caring for a client who has an order for ceftriaxone IV. The client is awake and alert and has been taking PO medications and eating. The IV ceftriaxone is not available in the automatic medication dispenser. What should the nurse do next?
- A. hold the medication since the client is afebrile
- B. call the pharmacy to send up the missing IV medication
- C. obtain the PO ceftriaxone from the medication dispenser and administer it
- D. call the health care provider and see if the client can be switched over to oral ceftriaxone
Correct Answer: B
Rationale: Calling the pharmacy (B) ensures the ordered IV ceftriaxone is provided. Holding the dose (A) risks treatment failure, administering PO without an order (C) is unsafe, and switching to PO (D) requires provider approval.
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The nurse is educating a client who is newly diagnosed with angina about his newly prescribed nitroglycerin. The nurse understands that teaching is effective when the client makes which statement?
- A. It is safe to take one dose of nitroglycerin if I am taking sildenafil.
- B. I should chew up three tablets at once, and then call 91-1 if I still have chest pain in 15 minutes.
- C. I can take up to three tablets, 5 minutes apart, under my tongue as needed for chest pain.
- D. I can keep the pills in a glass cup on my nightstand so I can reach them easily in an emergency.
Correct Answer: C
Rationale: Nitroglycerin is taken sublingually, up to three doses 5 minutes apart, for chest pain. Sildenafil is contraindicated, chewing tablets is incorrect, and glass cups expose pills to light and air, reducing potency.
The nurse is caring for a client taking sulfonamides to treat a urinary tract infection. Which of the following should the nurse monitor for in this client? Select all that apply.
- A. fever or sore throat
- B. reddish-pink urine
- C. side effects such as dyspnea, chest pains, chills, and cough
- D. urinary output of 1200 mL daily to minimize the risk of renal damage
- E. the need to decrease the dosage if the client takes warfarin sodium (Coumadin) or phenytoin (Dilantin)
Correct Answer: A,C,D,E
Rationale: Sulfonamides require monitoring for hypersensitivity (fever, sore throat—A; respiratory symptoms—C), adequate urine output (D) to prevent crystalluria, and drug interactions with warfarin/phenytoin (E). Reddish-pink urine (B) is not typical.
The nurse is preparing to administer pilocarpine hydrochloride eye drops to a client with glaucoma. Which is the correct technique to administer eye drops? Select all that apply.
- A. instruct the client to tilt the head back and look up
- B. pull the upper lid up and place the drops just above the pupil
- C. pull the lower lid down and place the drop into the conjunctival sac
- D. to instill multiple drops, wait 3 to 5 minutes between drops to allow maximum absorption
- E. instruct the client to close the eyes and gently rub the eyelids to ensure maximum absorption
Correct Answer: A,C,D
Rationale: Correct technique includes tilting the head back (A), placing drops in the conjunctival sac (C), and waiting 3-5 minutes between drops (D). Drops should not be placed above the pupil (B), and rubbing eyelids (E) risks contamination and reduced absorption.
The nurse is educating a client about MAOI and diet. Which dietary selection by the client indicates that the nurse's teaching was effective?
- A. egg-white omelet with a cup of yogurt
- B. baked chicken breast with green beans
- C. scrambled eggs with sausage and toast
- D. hot dog with sauerkraut, beans, and a fruit cup
Correct Answer: A
Rationale: MAOIs require a tyramine-free diet to prevent hypertensive crisis. Egg whites and yogurt are low-tyramine, unlike sausage, sauerkraut, and hot dogs, which are high-tyramine.