Nokea
A client is being treated for an atrial dysrhythmia with quinidine gluconate. Which statement by the client indicates to the nurse that the medication instructions about what to do if a dose is missed have been understood?
- A. I should call my primary health care provider.
- B. I should take the next prescribed dose as usual.
- C. I should take the dose as soon as I realize I've missed it.
- D. I take two doses of the medication at the next scheduled time.
Correct Answer: B
Rationale: Quinidine gluconate needs to be taken exactly as prescribed. Because of the action and effects of this medication, the client should be instructed to take the medication if remembered within 2 hours of the missed dose, or omit the dose and then resume the normal schedule. There is no need to call the doctor. It is not safe to take the dose whenever it is remembered or to take an extra dose.
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Disulfiram has been prescribed for a client, and the nurse provides instructions to the client about the medication. Which statement by the client indicates the need for further teaching?
- A. I must be careful taking cold medicines.
- B. I will have to check my aftershave lotion.
- C. I'll be fine as long as I don't drink alcohol.
- D. I need to be careful with ingredients when I cook.
Correct Answer: C
Rationale: Clients who are taking disulfiram must be taught that substances that contain alcohol can trigger an adverse reaction. Sources of hidden alcohol include foods (soups, sauces, and vinegars), medicine (cold medicine), mouthwashes, and skin preparations (alcohol rubs and aftershave lotions).
The home care nurse provides instructions about the management of pruritus to a client diagnosed with jaundice. Which statement made by the client suggests to the nurse that the client needs further teaching?
- A. I need to wear loose cotton clothing.
- B. A tepid water bath should help stop the itching.
- C. Keeping the house warmer is likely to lessen the itching
- D. I need to take the prescribed antihistamines as I'm supposed to.
Correct Answer: C
Rationale: Pruritus is caused by the accumulation of bile salts in the skin and results from obstructed biliary excretion. The client would be instructed to keep the house temperature cool in order to minimize the itching. The client should avoid the use of alkaline soap, and he or she (client) should wear loose, soft, cotton clothing. Antihistamines may relieve the itching, as will tepid water and emollient baths.
A client with a short leg plaster cast reports intense itching under the cast. The nurse provides instructions to the client regarding relief measures for the itching. Which statement by the client indicates an understanding of the measures used to relieve the itching?
- A. I can use the blunt part of a ruler to scratch the area.
- B. I can trickle small amounts of water down inside the cast.
- C. I need to obtain assistance when placing an object into the cast for the itching.
- D. I can use a hair dryer on the low setting and allow the air to blow into the cast.
Correct Answer: D
Rationale: Itching is a common complaint of clients with casts. Objects should not be put inside a cast because of the risk of scratching the skin and providing a point of entry for bacteria. A plaster cast can break down when wet. Therefore, the best way to relieve itching is with the forceful injection of air inside the cast.
The nurse performs an initial assessment on a pregnant client and determines that the client is at risk for toxoplasmosis. The nurse provides education to the client on how to prevent the disease. Which statement by the client indicates that teaching has been effective?
- A. It's alright to eat raw meats.
- B. I should wash hands only before meals.
- C. I should avoid exposure to litter boxes used by my cat.
- D. I should use topical corticosteroid treatments prophylactically.
Correct Answer: C
Rationale: Infected house cats transmit toxoplasmosis through the feces. Handling litter boxes can transmit the disease to the pregnant client. Meats that are undercooked can harbor microorganisms that can cause infection. Hands should be washed frequently throughout the day. The use of topical corticosteroids will not prevent exposure to the disease.
The nurse has given instructions about site care to a hemodialysis client who had an implantation of an arteriovenous (AV) fistula in the right arm. Which statement by the client indicates a need for further teaching?
- A. I will need to sleep on my right side.
- B. It's important that I don't carry heavy objects with the right arm.
- C. I will perform range-of-motion exercises routinely on my right arm.
- D. It's important that I report any right arm redness or drainage at the site.
Correct Answer: A
Rationale: Routine instructions to the client with an AV fistula, graft, or shunt include avoiding sleeping with the body weight on the extremity with the access site, avoiding carrying heavy objects or compressing the extremity that has the access site, performing routine range-of-motion exercises of the affected extremity, and reporting signs and symptoms of infection.