Nokea
A client being discharged from the hospital with a prescription for quinidine to control ventricular ectopy is provided medication instructions by the nurse. Which statement by the client would indicate the need for further teaching?
- A. The best time to schedule this medication is with my meals.
- B. I need to take this medication regularly, even if my heart feels strong.
- C. I should avoid alcohol, caffeine, and cigarettes while on this medication.
- D. If I get diarrhea, nausea, or vomiting, I need to stop the medication immediately.
Correct Answer: D
Rationale: Diarrhea, nausea, vomiting, loss of appetite, and dizziness are all common side effects of quinidine. If these should occur, the primary health care provider or nurse should be notified, but the medication should never be stopped by the client. A rapid decrease in the medication level of an antidysrhythmic could precipitate dysrhythmia. The remaining options are accurate client statements.
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The nurse is caring for a client with a history of atrial fibrillation who is prescribed dofetilide (Tikosyn). The nurse should monitor the client for which of the following side effects?
- A. Hypertension.
- B. Bradycardia.
- C. Torsades de pointes.
- D. Weight gain.
Correct Answer: C
Rationale: Dofetilide can cause torsades de pointes, a life-threatening arrhythmia, requiring close monitoring.
A client with a history of depression is prescribed escitalopram (Lexapro). The nurse should instruct the client to report which of the following side effects immediately?
- A. Mild headache.
- B. Suicidal thoughts.
- C. Nausea.
- D. Fatigue.
Correct Answer: B
Rationale: Suicidal thoughts are a serious side effect of escitalopram, requiring immediate reporting to ensure client safety.
Select the sound that is heard with percussion with its description.
- A. Tympany: A hollow sound
- B. Dullness: A thud like sound
- C. Dullness: A hollow sound
- D. Resonance: A booming sound
Correct Answer: A,B,D
Rationale: Tympany is a hollow sound (e.g., over air-filled structures like the stomach), dullness is a thud-like sound (e.g., over solid organs like the liver), and resonance is a booming sound (e.g., over lung tissue). Option C is incorrect because dullness is not a hollow sound.
A client with a fractured femur is placed in skeletal traction. The nurse should assess the client for which of the following complications?
- A. Pressure ulcers.
- B. Deep vein thrombosis.
- C. Hypovolemia.
- D. Infection at the pin sites.
Correct Answer: B,D
Rationale: Skeletal traction increases the risk of deep vein thrombosis due to immobility and infection at pin sites due to skin penetration.
A client who is paraplegic cannot feel her lower extremities and has been positioned on her side. The nurse should inspect which of the following areas that is a potential pressure point when the client is in this position?
- A. Sacrum.
- B. Occiput.
- C. Ankles.
- D. Heel.
Correct Answer: C
Rationale: When side-lying, the ankles are a common pressure point due to prolonged contact with the bed. The sacrum, occiput, and heel are more at risk in other positions like supine.