Nokea
A client has a prescription for albuterol (Proventil HFA) (two puffs) and beclomethasone dipropionate (Qvar) (nasal inhalation, two puffs) by metered-dose inhaler. The medications are to be administered by the nurse by giving the:
- A. Albuterol first and then the beclomethasone dipropionate
- B. Beclomethasone dipropionate first and then the albuterol
- C. Alternating a single puff of each, beginning with the albuterol
- D. Alternating a single puff of each, beginning with the beclomethasone dipropionate
Correct Answer: A
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.
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A home health care nurse is visiting a client with elevated triglyceride levels and a serum cholesterol level of 398 mg/dL. The client is taking cholestyramine (Questran). Which of the following statements, if made by the client, indicates the need for further education?
- A. Constipation and bloating might be a problem.
- B. I'll continue to watch my diet and reduce my fats.
- C. Walking a mile each day will help the whole process.
- D. I'll continue my nicotinic acid from the health food store.
Correct Answer: D
Rationale: Nicotinic acid, even an over-the-counter form, should be avoided because it may lead to liver abnormalities. All lipid-lowering medications also can cause liver abnormalities, so a combination of nicotinic acid and cholestyramine resin is to be avoided. Constipation and bloating are the two most common side effects. Walking and the reduction of fats in the diet are therapeutic measures to reduce cholesterol and triglyceride levels.
When administering etanercept (Enbrel) to a client with rheumatoid arthritis for 3 weeks, what is the most important assessment for the nurse to perform?
- A. Assessing the injection site for itching and edema
- B. Monitoring white blood cell counts and platelet counts
- C. Evaluating for fatigue and joint pain in the client
- D. Checking for a metallic taste in the mouth and loss of appetite
Correct Answer: B
Rationale: The priority when administering etanercept (Enbrel) to a client with rheumatoid arthritis is to monitor white blood cell counts and platelet counts. Etanercept can lead to infections and pancytopenia, making it crucial to assess for changes in these blood parameters to detect any potential complications early on.
A client with hypertension is prescribed lisinopril (Zestril). Which instruction should the nurse include in the teaching plan?
- A. Avoid foods high in potassium.
- B. Avoid taking the medication with grapefruit juice.
- C. Monitor blood pressure regularly.
- D. Report any swelling of the lips or face.
Correct Answer: D
Rationale: The correct instruction for the nurse to include in the teaching plan is to 'Report any swelling of the lips or face.' Lisinopril (Zestril) can cause angioedema, which is swelling of the lips or face. This is a serious side effect that should be reported immediately. Clients do not need to avoid potassium-rich foods unless instructed by their healthcare provider, should avoid taking the medication with grapefruit juice, and should monitor their blood pressure regularly, not just weekly.
The client with ovarian cancer is being treated with vincristine (Oncovin). The nurse monitors the client, knowing that which of the following indicates a side effect specific to this medication?
- A. Diarrhea
- B. Hair loss
- C. Chest pain
- D. Numbness and tingling in the fingers and toes
Correct Answer: D
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.
A nurse is monitoring a client receiving lithium carbonate for bipolar disorder. Which finding should the nurse report immediately to the healthcare provider?
- A. Increased thirst
- B. Fine hand tremors
- C. Frequent urination
- D. Persistent vomiting
Correct Answer: D
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.