Nokea
A client has a new prescription for Metronidazole. Which of the following instructions should be included?
- A. Avoid drinking alcohol while taking this medication.
- B. Take the medication on an empty stomach.
- C. Increase your intake of green, leafy vegetables.
- D. Discontinue the medication if you experience a metallic taste.
Correct Answer: A
Rationale: The correct instruction for a client prescribed Metronidazole is to avoid drinking alcohol while taking this medication. Metronidazole can cause a disulfiram-like reaction when combined with alcohol, resulting in severe nausea, vomiting, and other adverse effects. Therefore, it is crucial for clients to refrain from consuming alcohol during treatment to prevent these potential complications. Choice B is incorrect because Metronidazole can be taken with or without food. Choice C is irrelevant as there is no specific requirement to increase green, leafy vegetable intake with Metronidazole. Choice D is incorrect as a metallic taste is a known side effect of Metronidazole but does not necessarily indicate the need to discontinue the medication.
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What should you monitor when administering Clopidogrel to a patient?
- A. Signs of thrombotic thrombocytopenic purpura
- B. Bleeding during therapy
- C. CBC with differential and platelet count
- D. All of the above
Correct Answer: D
Rationale: When administering Clopidogrel, it is crucial to monitor for signs of thrombotic thrombocytopenic purpura, bleeding during therapy, and changes in CBC with differential and platelet count. Thrombotic thrombocytopenic purpura is a rare but serious condition associated with Clopidogrel use, characterized by microangiopathic hemolytic anemia, thrombocytopenia, neurological symptoms, fever, and renal dysfunction. Monitoring for signs of thrombotic thrombocytopenic purpura is essential to detect this potentially life-threatening condition early. Monitoring for bleeding helps to assess the risk of hemorrhagic events, a known side effect of Clopidogrel. Additionally, regular monitoring of CBC with differential and platelet count is necessary to evaluate the drug's impact on blood cell counts and detect any abnormalities that may require intervention. Therefore, monitoring all these parameters is vital to ensure patient safety and appropriate management during Clopidogrel therapy.
When preparing to administer IV Acyclovir for Herpes Zoster, what action should the nurse take?
- A. Infuse the medication over 1 hour.
- B. Monitor the client's blood pressure every 15 minutes during infusion.
- C. Administer a stool softener.
- D. Monitor the client's blood glucose level every 4 hours during infusion.
Correct Answer: A
Rationale: The correct action for the nurse is to infuse IV Acyclovir over at least 1 hour to prevent nephrotoxicity. Rapid infusion can lead to adverse effects, so a slow infusion rate is crucial for patient safety. Monitoring blood pressure, administering a stool softener, or monitoring blood glucose levels are not directly related to the administration of IV Acyclovir for Herpes Zoster.
A patient was admitted to the emergency department with a pulse oximeter reading of 85% after a successful prehospital resuscitation from cardiac arrest due to an asthma attack. What is the most important initial drug to administer as ordered?
- A. Epinephrine
- B. Sodium bicarbonate
- C. Albuterol
- D. Oxygen
Correct Answer: D
Rationale: Oxygen is the most important initial intervention for a patient with a low pulse oximeter reading (85%) to correct hypoxia and prevent further complications. While epinephrine (A) and albuterol (C) are used to treat asthma, oxygen is the priority to address the immediate hypoxia. Sodium bicarbonate (B) is not indicated unless there is severe metabolic acidosis.
The client tells the nurse that her symptoms have become worse since she has been using oxymetazoline (Afrin) for nasal congestion. What is the best assessment question for the nurse to ask?
- A. How old is the bottle you are using?'
- B. May I take your temperature?'
- C. Are you using any other inhaled medications?'
- D. How long have you been using the medication?'
Correct Answer: D
Rationale: Oxymetazoline, a nasal decongestant, can cause rebound congestion (rhinitis medicamentosa) if used beyond 3-5 days, worsening symptoms due to vascular dependence. The best assessment question is how long the client has used it, as prolonged use is the likely culprit, guiding the nurse to educate on discontinuation or seek medical advice. The bottle's age might affect potency but isn't the primary concern for worsening symptoms. Temperature checks for infection, a secondary issue here. Other inhaled medications could interact but don't directly explain rebound effects. The nurse prioritizes duration to pinpoint misuse, a common issue with topical decongestants, making choice D critical for accurate assessment and intervention.
When educating a client with a new prescription for Omeprazole to manage GERD, which of the following information should the nurse include?
- A. Take the medication before meals.
- B. You may need to take this medication for a long time.
- C. Increase your intake of vitamin C while taking this medication.
- D. Expect immediate relief of symptoms.
Correct Answer: A
Rationale: The correct answer is to take the medication before meals. Omeprazole should be taken before meals to ensure its effectiveness in reducing stomach acid production. This timing allows the medication to work on reducing acid secretion when the stomach is most actively producing it, leading to better control of symptoms. Choice B is incorrect because not all patients with GERD need to take Omeprazole for the rest of their lives; the duration of treatment varies. Choice C is incorrect as there is no specific recommendation to increase vitamin C intake while taking Omeprazole. Choice D is incorrect because Omeprazole may take a few days to start providing symptom relief, so immediate relief should not be expected.