Nokea
A client presenting with complaints of not feeling well is seen in a clinic. The client is taking several medications for the control of heart disease and hypertension, including a beta-blocker, digoxin (Lanoxin), and a diuretic. A tentative diagnosis of digoxin toxicity is made. Which of the following assessment data would support this diagnosis?
- A. Dyspnea, edema, and palpitations
- B. Chest pain, hypotension, and paresthesia
- C. Double vision, loss of appetite, and nausea
- D. Constipation, dry mouth, and sleep disorder
Correct Answer: C
Rationale: The correct answer is C. Double vision, loss of appetite, and nausea are classic signs of digoxin toxicity. Other signs may include bradycardia, visual disturbances, and confusion. These symptoms are indicators that the client may be experiencing adverse effects due to elevated levels of digoxin in the system, requiring immediate medical attention to prevent serious complications.
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A client is prescribed calcium gluconate after thyroidectomy. The medication is most likely prescribed to:
- A. Treat thyroid storm.
- B. Prevent cardiac irritability.
- C. Treat hypocalcemic tetany.
- D. Stimulate the release of parathyroid hormone.
Correct Answer: C
Rationale: After a thyroidectomy, the parathyroid glands can be inadvertently removed or damaged, leading to a decrease in calcium levels and potentially causing hypocalcemic tetany. Calcium gluconate is given to supplement calcium levels and prevent or treat hypocalcemia-related symptoms, such as muscle spasms and tetany.
The clinic nurse is performing an admission assessment on a client. The nurse notes that the client is taking azelaic acid (Azelex). Because of the medication prescription, the nurse would suspect that the client is being treated for:
- A. Acne
- B. Eczema
- C. Hair loss
- D. Herpes simplex
Correct Answer: A
Rationale: Azelaic acid (Azelex) is a topical medication used to treat mild to moderate acne. It works by suppressing the growth of Propionibacterium acnes and decreasing the proliferation of keratinocytes in the skin. Therefore, if a client is prescribed azelaic acid, the nurse would suspect that the client is being treated for acne.
A client who has begun taking fosinopril (Monopril) is very distressed, telling the nurse that he cannot taste food normally since beginning the medication 2 weeks ago. The nurse provides the best support to the client by:
- A. Telling the client not to take the medication with food
- B. Suggesting that the client taper the dose until taste returns to normal
- C. Informing the client that impaired taste is expected and generally disappears in 2 to 3 months
- D. Requesting that the health care provider (HCP) change the prescription to another brand of angiotensin-converting enzyme (ACE) inhibitor
Correct Answer: C
Rationale: The correct answer is to inform the client that impaired taste is an expected side effect of ACE inhibitors like fosinopril, such as Monopril, and typically resolves within 2 to 3 months. It is essential for the nurse to offer reassurance and education to the client about this common side effect to alleviate distress and encourage compliance with the medication regimen.
A client has begun therapy with theophylline (Theo-24). The nurse tells the client to limit the intake of which of the following while taking this medication?
- A. Oranges and pineapple
- B. Coffee, cola, and chocolate
- C. Oysters, lobster, and shrimp
- D. Cottage cheese, cream cheese, and dairy creamers
Correct Answer: B
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.
After administering acetylcysteine (Mucomyst), 20% solution diluted in 0.9% normal saline by nebulizer, the nurse should have which item available for potential use?
- A. Ambu bag
- B. Intubation tray
- C. Nasogastric tube
- D. Suction equipment
Correct Answer: D
Rationale: Acetylcysteine is administered via inhalation as a mucolytic. It helps liquefy secretions, making it easier for the client to clear them. However, in some cases, the increased volume of liquefied secretions may be challenging for the client to manage, leading to the potential need for suction equipment to assist in clearing the airway. Therefore, the nurse should have suction equipment available after administering acetylcysteine to address any issues related to excessive secretions.