Nokea
A client has been prescribed metoclopramide on a long-term basis. A home care nurse calls the primary health care provider immediately if which side effect is noted in this client?
- A. Excitability
- B. Anxiety or irritability
- C. Uncontrolled rhythmic movements of the face or limbs
- D. Dry mouth not minimized by the use of sugar-free hard candy
Correct Answer: C
Rationale: Metoclopramide is a 'prokinetic' drug used to treat heartburn. If the client experiences tardive dyskinesia (rhythmic movements of the face or limbs), the nurse should withhold the medication and call the primary health care provider. These side effects may be irreversible. Excitability is not a side effect of this medication. Anxiety, irritability, and dry mouth are milder side effects that are not harmful to the client.
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Which of the following would be most important for the nurse to include in the teaching plan for a client who is taking phenelzine (Nardil)?
- A. Eating a normal amount of salt in the diet.
- B. Drinking 10 to 12 glasses of water each day.
- C. Allowing 10 days to achieve therapeutic effects.
- D. Avoiding foods high in tyramine.
Correct Answer: D
Rationale: Phenelzine, an MAOI, requires avoiding tyramine-rich foods to prevent hypertensive crisis.
A client is admitted with severe abdominal pains and the diagnosis of acute pancreatitis. The nurse should develop a plan of care during the acute phase of pancreatitis that will involve interventions targeting which of the following problems?
- A. Drug and alcohol abuse.
- B. Risk for injury.
- C. Severe pain.
- D. Ineffective airway clearance.
Correct Answer: C
Rationale: Severe pain is a primary concern in acute pancreatitis, requiring targeted interventions like analgesics.
A client with a history of tuberculosis is prescribed isoniazid. Which supplement should the nurse administer concurrently?
- A. Vitamin C
- B. Vitamin B6
- C. Vitamin D
- D. Vitamin K
Correct Answer: B
Rationale: Isoniazid can cause peripheral neuropathy due to vitamin B6 deficiency, so pyridoxine (vitamin B6) is administered to prevent this side effect.
An expected physiologic response to a low potassium level is:
- A. Cardiac dysrhythmias.
- B. Hyperglycemia.
- C. Hypertension.
- D. Increased energy.
Correct Answer: A
Rationale: Hypokalemia can cause cardiac dysrhythmias due to its effect on cardiac muscle excitability, making it the most significant physiologic response.
The nurse should assess the child with nephrotic syndrome for which of the following? Select all that apply.
- A. Normal blood pressure.
- B. Generalized edema.
- C. Normal serum lipid levels.
- D. No red blood cells in the urine.
- E. Elevated streptococcal antibody titers.
Correct Answer: B,D
Rationale: Nephrotic syndrome is characterized by generalized edema and no red blood cells in the urine. Blood pressure may be elevated, serum lipids are typically high, and streptococcal antibodies are not typically associated.