Nokea
A client has a prescription for Timolol eye drops for the treatment of glaucoma. Which of the following instructions should the nurse include?
- A. Apply gentle pressure to the nasolacrimal duct for 30 to 60 seconds after application.
- B. Avoid blinking immediately after instilling the drops.
- C. Keep your eyes closed for 5 minutes after application.
- D. Administer the drops directly onto the cornea.
Correct Answer: A
Rationale: The correct instruction for the nurse to include is to apply gentle pressure to the nasolacrimal duct for 30 to 60 seconds after application. This technique helps prevent systemic absorption of the medication, reducing the risk of systemic side effects. By applying pressure, the drainage of the medication into the bloodstream through the nasolacrimal duct is minimized, enhancing the drug's local ocular effects. Choices B, C, and D are incorrect because blinking immediately after instilling the drops, keeping eyes closed for 5 minutes, and administering the drops directly onto the cornea are not recommended practices for administering Timolol eye drops.
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A client with a prescription for Vasopressin to treat Diabetes Insipidus is being taught by a healthcare professional. Which of the following client statements indicates an understanding of the teaching?
- A. I will reduce my sodium intake.
- B. I should increase my water intake.
- C. I will notify my doctor if I develop chest pain.
- D. I should take this medication with food.
Correct Answer: C
Rationale: The correct answer is C because Vasopressin can cause vasoconstriction, potentially leading to chest pain. It is crucial for the client to inform their healthcare provider immediately if they experience chest pain while on Vasopressin therapy to address any potential cardiovascular complications promptly. Choices A, B, and D are incorrect. While maintaining adequate hydration is essential with Vasopressin therapy due to its antidiuretic effect, increasing water intake is not the most critical aspect to monitor. Reducing sodium intake may be beneficial in some cases but is not directly related to the potential side effects of Vasopressin. Taking the medication with food is not a specific instruction for Vasopressin administration.
A client has anemia and a new prescription for ferrous sulfate liquid. Which of the following instructions should the nurse provide?
- A. Take the medication on an empty stomach to decrease gastrointestinal irritation.
- B. Take the medication with orange juice to enhance absorption.
- C. Take the medication with milk.
- D. Rinse the mouth before taking the iron.
Correct Answer: B
Rationale: Taking ferrous sulfate with orange juice can help increase the absorption of iron. Orange juice contains vitamin C, which aids in the absorption of iron from the medication. This combination can enhance the effectiveness of the iron supplement for a client with anemia. Option A is incorrect because taking iron on an empty stomach can cause gastrointestinal upset. Option C is incorrect because calcium in milk can inhibit iron absorption. Option D is irrelevant to enhancing iron absorption.
How do ACE inhibitors work?
- A. Block the vasoconstrictor and aldosterone effects of angiotensin II at the receptor site
- B. Block stimulation of beta 1 and beta 2 at the receptor sites
- C. Block the conversion of angiotensin I to the vasoconstrictor angiotensin II
- D. None of the above
Correct Answer: C
Rationale: ACE inhibitors work by inhibiting the conversion of angiotensin I to angiotensin II. Angiotensin II is a potent vasoconstrictor, and by blocking its production, ACE inhibitors help dilate blood vessels, reduce blood pressure, and decrease the workload of the heart. Choice A is incorrect because it describes the mechanism of action of angiotensin receptor blockers (ARBs), not ACE inhibitors. Choice B is incorrect as it describes beta-blockers, not ACE inhibitors. Choice D is incorrect as ACE inhibitors do have a specific mechanism of action.
A client with HIV-1 infection is prescribed zidovudine as part of antiretroviral therapy. The nurse should monitor the client for which of the following adverse effects of this medication?
- A. Cardiac dysrhythmia
- B. Metabolic alkalosis
- C. Renal failure
- D. Aplastic anemia
Correct Answer: D
Rationale: Corrected Rationale: Zidovudine is associated with the development of aplastic anemia, a serious adverse effect characterized by bone marrow suppression. Regular monitoring is essential to detect this side effect early and prevent complications. Cardiac dysrhythmia, metabolic alkalosis, and renal failure are not commonly associated with zidovudine use, making them incorrect choices for adverse effects of this medication.
A nurse in a clinic is caring for a group of clients. The nurse should contact the provider about a potential contraindication to a medication for which of the following clients? (Select all that apply.)
- A. A client at 8 weeks of gestation who asks for an Influenza immunization
- B. A client who takes Prednisone and has a possible Fungal infection
- C. A client who has chronic liver disease and is taking Hydrocodone
- D. A client who has Peptic Ulcer Disease, takes Sucralfate, and tells the nurse she has started taking OTC Aluminum Hydroxide
Correct Answer: B
Rationale: Prednisone, a glucocorticoid, should not be taken by a client who has a possible systemic fungal infection as it can worsen the infection. This combination can suppress the immune response, allowing the fungal infection to proliferate. Therefore, the nurse should contact the provider regarding this potential contraindication to medication. The other options do not present a contraindication related to the medication interactions described in the question.