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A client is prescribed nitroglycerin sublingual tablets. The practical nurse should reinforce which instruction?
- A. Store the tablets in a cool, dry place.
- B. Take one tablet every 5 minutes until pain is relieved, up to three tablets.
- C. Swallow the tablets whole.
- D. Chew the tablets for faster relief.
Correct Answer: A
Rationale: Nitroglycerin sublingual tablets are sensitive to heat and moisture, so they should be stored in a cool, dry place to maintain their efficacy. Choice B is incorrect because nitroglycerin tablets should be taken as directed by the healthcare provider. Choice C is incorrect because sublingual tablets should be placed under the tongue to dissolve, not swallowed. Choice D is incorrect because sublingual tablets should not be chewed; they are meant to be absorbed through the tissues under the tongue.
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Which action should be taken to assess for analgesic tolerance in a client who is unable to communicate?
- A. Review the client's laboratory values for changes in peak and trough levels of the analgesic
- B. Prolong the interval between analgesic medication doses and monitor the client's vital signs
- C. Observe the client for the presence of pain behaviors before the next analgesic dose is due
- D. Ask family members to report behaviors suggesting that the client's pain has returned
Correct Answer: C
Rationale: In clients who are unable to communicate, observing for pain behaviors is crucial in assessing analgesic tolerance. Changes in pain behaviors can indicate if the current analgesic regimen is effective or if tolerance has developed. Therefore, closely observing the client for pain behaviors before the next analgesic dose helps healthcare providers evaluate the client's response to pain management.
A client with a history of deep vein thrombosis is prescribed fondaparinux. The nurse should monitor for which potential adverse effect?
- A. Increased risk of bleeding
- B. Decreased risk of bleeding
- C. Increased risk of infection
- D. Decreased risk of infection
Correct Answer: A
Rationale: Corrected Question: When a client with a history of deep vein thrombosis is prescribed fondaparinux, the nurse should monitor for the potential adverse effect of an increased risk of bleeding. Fondaparinux is an anticoagulant that works by preventing blood clots, which can lead to an increased risk of bleeding. Therefore, the nurse should closely monitor the client for signs of bleeding, such as unexplained bruising, bleeding gums, or blood in the urine or stool.
When a client with hepatic encephalopathy is receiving lactulose, which parameter is essential to monitor for a response to the drug?
- A. Serum hepatic enzymes
- B. Fingerstick glucose
- C. Stool color and character
- D. Serum electrolytes and ammonia
Correct Answer: D
Rationale: In hepatic encephalopathy, the goal of lactulose therapy is to reduce blood ammonia levels by promoting its excretion in the stool. Therefore, monitoring serum electrolytes and ammonia levels is crucial to assess the effectiveness of lactulose in lowering ammonia levels and improving the client's condition.
A healthcare professional prepares to administer a scheduled dose of labetalol by mouth to a client with hypertension. The client's heart rate is 48 beats/min, respirations are 16 breaths/min, and blood pressure is 150/90 mmHg.
- A. Administer the dose and monitor the client's blood pressure regularly
- B. Apply a telemetry monitor before administering the dose
- C. Assess for orthostatic hypotension before administering the dose
- D. Withhold the scheduled dose and notify the healthcare provider
Correct Answer: D
Rationale: The client's low heart rate of 48 beats/min indicates bradycardia, a potential side effect of labetalol. Administering the dose in this case could further lower the heart rate, potentially causing adverse effects. Therefore, it is crucial to withhold the scheduled dose and notify the healthcare provider for further assessment and guidance.
A client is prescribed phenytoin for the management of seizures. What instruction should the practical nurse provide to the client regarding this medication?
- A. Take the medication at the same time every day.
- B. Discontinue the medication if a rash develops.
- C. Avoid consuming dairy products.
- D. Monitor blood pressure regularly.
Correct Answer: A
Rationale: The correct instruction the practical nurse should provide to the client regarding phenytoin is to take the medication at the same time every day. This consistency helps maintain a steady level of the medication in the bloodstream, which is crucial for effectively managing seizures. It is important for clients to adhere to their prescribed dosing schedule to optimize the therapeutic benefits of phenytoin.