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 healthcare professional in a provider's clinic is caring for a client who reports erectile dysfunction and requests a prescription for sildenafil. Which of the following medications currently prescribed for the client is a contraindication to taking sildenafil?
- A. Isosorbide
- B. Phenytoin
- C. Metronidazole
- D. Prednisone
Correct Answer: A
Rationale: Sildenafil is contraindicated with nitrates like isosorbide due to the risk of severe hypotension. Isosorbide is a nitrate that can potentiate the hypotensive effects of sildenafil, leading to a dangerous drop in blood pressure. Therefore, it is essential to avoid concurrent use of isosorbide and sildenafil to prevent adverse effects. Phenytoin, metronidazole, and prednisone do not have significant interactions with sildenafil and are not contraindicated when used together.
A client has a new prescription for Sulfasalazine for the treatment of Crohn's disease. Which of the following instructions should the nurse include?
- A. Expect orange-yellow discoloration of urine and skin.
- B. Take the medication with food.
- C. Do not discontinue the medication if a sore throat occurs.
- D. Avoid prolonged exposure to sunlight.
Correct Answer: A
Rationale: The correct answer is A: 'Expect orange-yellow discoloration of urine and skin.' Sulfasalazine can cause this harmless side effect, which does not require discontinuation of the medication. Option B is incorrect because Sulfasalazine is usually taken with food to minimize gastrointestinal side effects. Option C is incorrect as a sore throat is not a common reason to stop the medication. Option D is not directly related to the side effects of Sulfasalazine.
A client has a new prescription for Cyclobenzaprine to treat muscle spasms. Which of the following instructions should the nurse include in the teaching?
- A. Avoid driving or operating heavy machinery while taking this medication.
- B. Take this medication on an empty stomach for best results.
- C. Take this medication only when experiencing muscle pain.
- D. Increase your intake of potassium-rich foods while taking this medication.
Correct Answer: A
Rationale: The correct instruction that the nurse should include in the teaching for a client prescribed Cyclobenzaprine is to avoid driving or operating heavy machinery while taking this medication. Cyclobenzaprine can cause drowsiness, so it is important to advise clients to avoid activities that require alertness and coordination to prevent accidents or injuries. Choice B is incorrect because Cyclobenzaprine can be taken with or without food. Choice C is incorrect because Cyclobenzaprine is typically taken regularly as prescribed, not just when experiencing muscle pain. Choice D is incorrect because there is no specific need to increase potassium-rich foods while taking Cyclobenzaprine.
While caring for a client receiving IV heparin, which of the following findings should the nurse identify as an adverse effect of this medication?
- A. Hypertension
- B. Hyperglycemia
- C. Thrombocytopenia
- D. Leukopenia
Correct Answer: C
Rationale: Thrombocytopenia, a decrease in platelet count, is a known adverse effect associated with heparin therapy. It can lead to an increased risk of bleeding and should be closely monitored during treatment. Choices A, B, and D are incorrect. Hypertension is not typically associated with heparin use; hyperglycemia is not a common adverse effect of heparin; leukopenia is not a primary side effect of heparin therapy.
When a client reports urticaria and dyspnea after receiving amoxicillin/clavulanic acid, which medication should be administered first?
- A. Administer epinephrine
- B. Administer albuterol
- C. Administer diphenhydramine
- D. Administer prednisone
Correct Answer: A
Rationale: In the scenario described, the client is experiencing symptoms of a severe allergic reaction. The priority intervention is to administer epinephrine. Epinephrine acts quickly to reverse the effects of the allergic reaction and can be life-saving in cases of anaphylaxis. Albuterol is used for bronchodilation and may help with respiratory symptoms but is not the first-line treatment for anaphylaxis. Diphenhydramine and prednisone are used for allergic reactions but are not as rapid-acting as epinephrine and should be considered after administering epinephrine in this situation.