Nokea
A 59-year-old client is prescribed furosemide 40 mg twice a day for the management of heart failure. The practical nurse should monitor the client for the development of which complication?
- A. Hypokalemia
- B. Hyperchloremia
- C. Hypercalcemia
- D. Hypophosphatemia
Correct Answer: A
Rationale: Furosemide is a loop diuretic that inhibits the reabsorption of sodium and chloride in the kidneys, leading to increased potassium excretion and potentially causing hypokalemia. Hypokalemia can lead to cardiac irregularities, making it crucial for the practical nurse to monitor the client for this electrolyte imbalance.
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A client with pulmonary tuberculosis has been taking rifampin for 3 weeks. The client reports orange urine. What should be the nurse's next action?
- A. Notify the client's health care provider.
- B. Inform the client that this is not harmful.
- C. Assess the client for other signs of nephrotoxicity.
- D. Monitor the client's most recent creatinine level.
Correct Answer: B
Rationale: The correct action for the nurse to take when a client reports orange urine after taking rifampin is to inform the client that this change is not harmful. Rifampin is known to cause orange discoloration of urine, which is a harmless side effect. There is no need to notify the health care provider as this is an expected outcome. Monitoring creatinine levels or assessing for nephrotoxicity is unnecessary in this situation, as rifampin does not typically cause kidney damage.
A client with gastroesophageal reflux disease (GERD) is prescribed omeprazole. The nurse should reinforce which instruction?
- A. Take this medication in the morning before breakfast.
- B. Take this medication with meals.
- C. Avoid taking this medication with antacids.
- D. Take this medication at bedtime.
Correct Answer: A
Rationale: The correct instruction for a client with GERD prescribed omeprazole is to take the medication in the morning before breakfast. Omeprazole works best when taken on an empty stomach, approximately 30 minutes before the first meal of the day. This timing maximizes its effectiveness in reducing stomach acid production and helps manage symptoms of GERD more efficiently.
A client with diabetes mellitus type 2 is prescribed pioglitazone. What instruction should the nurse include in the client's teaching plan?
- A. Report any signs of heart failure.
- B. Take this medication with meals.
- C. Avoid alcohol while taking this medication.
- D. Report any signs of bladder cancer.
Correct Answer: A
Rationale: The correct answer is to instruct the client to report any signs of heart failure when taking pioglitazone. Pioglitazone is known to potentially exacerbate heart failure, so it is crucial for clients to monitor and report any symptoms of heart failure promptly to their healthcare provider for appropriate management.
A 6-month-old infant is prescribed digoxin for the treatment of congestive heart failure. Which observation by the practical nurse (PN) warrants immediate intervention for signs of digoxin toxicity?
- A. Apical heart rate of 60 beats/min
- B. Sweating across the forehead
- C. Poor sucking effort
- D. Respiratory rate of 30 breaths/min
Correct Answer: A
Rationale: A heart rate of 60 beats/min for a 6-month-old infant warrants immediate intervention as it falls below the normal range. The normal heart rate for a 6-month-old is 80 to 150 beats/min when awake, and a rate of 70 beats/min while sleeping is considered within normal limits. Bradycardia (heart rate <60 beats/min) in infants can be a sign of digoxin toxicity, necessitating prompt evaluation and intervention to prevent adverse effects.
A client undergoing hemodialysis for chronic kidney disease is taking the medication erythropoietin. The nurse should reinforce instructions to explain for which reason this medication is prescribed?
- A. This drug prevents infections associated with dialysis.
- B. This drug prevents deep vein thrombosis in older clients.
- C. This drug helps stimulate the production of red blood cells.
- D. This drug helps balance the level of phosphorus in the body.
Correct Answer: C
Rationale: Erythropoietin is prescribed to stimulate the production of red blood cells. Clients undergoing hemodialysis often develop anemia due to end-stage renal disease. Erythropoietin helps in correcting this anemia by stimulating red blood cell production. It is not used to prevent infections associated with dialysis, deep vein thrombosis, or to balance phosphorus levels in the body.