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A client who is newly diagnosed with erosive esophagitis secondary to GERD experiences symptoms after taking lansoprazole PO for one full week. Which actions should the nurse take?
- A. Confirm that the client is taking the medication correctly
- B. Auscultate the client's bowel sounds and assess the apical pulse
- C. Advise the client that healing typically takes several weeks
- D. Notify the healthcare provider to consider a higher dose
Correct Answer: C
Rationale: It is essential for the nurse to educate the client that healing from erosive esophagitis typically takes several weeks to manage expectations. This information helps the client understand the timeline for improvement and reduces anxiety about the effectiveness of the treatment. It is not necessary to confirm the timing of medication intake, assess bowel sounds, or measure the apical pulse in this scenario. Since symptoms have persisted after one week of lansoprazole, it may not be appropriate to immediately escalate to a higher dose without further assessment or guidance from the healthcare provider.
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A client has sublingual nitroglycerine tablets prescribed to treat angina. The nurse realizes the client requires further education if the client makes which statements? (Select one that doesn't apply.)
- A. I will need to replace the nitroglycerine tablets every 3 to 5 months, not in a year.
- B. I should continue taking nitroglycerine tablets if I develop a headache.
- C. I understand nitroglycerine tablets do not cause addiction.
- D. If I feel dizzy when I take these, I should sit down or lie down until I feel better.
Correct Answer: D
Rationale: The correct answer is D. Nitroglycerine sublingual tablets need to be replaced every 3 to 5 months, not every year, making statement A incorrect. While nitroglycerine can cause a headache, it is important to continue taking the prescribed nitroglycerine if the client has angina, making statement B accurate. Nitroglycerine tablets do not cause addiction, so statement C is correct. Dizziness and weakness are associated with the hypotensive effect of nitroglycerine; therefore, if the client feels dizzy when taking them, they should sit down or lie down until they feel better. Taking nitroglycerine tablets before an activity known to cause angina can help prevent angina attacks.
During a home visit, a client with a history of angina reports frequent headaches. The client recently started a new prescription for diltiazem, a calcium channel blocker. What action should the nurse take?
- A. Explain the importance of obtaining a blood sample promptly to test for medication toxicity
- B. Consult with the healthcare provider regarding the necessity of an opioid analgesic for pain relief
- C. Recommend the client to discontinue the medication until contacting the healthcare provider
- D. Instruct the client on the use of acetaminophen every 4-6 hours as needed for headaches
Correct Answer: D
Rationale: The correct action for the nurse to take is to instruct the client to use acetaminophen for headaches. Acetaminophen is a suitable and safer option for managing headaches associated with calcium channel blockers like diltiazem. It is essential to avoid medications that can interact negatively with diltiazem, such as opioid analgesics, and to not discontinue the medication abruptly without consulting the healthcare provider. Monitoring for medication toxicity through blood samples is not typically indicated for managing headaches in this scenario.
A client arrives to the emergency department experiencing diabetic ketoacidosis (DKA). The healthcare provider prescribes an insulin intravenous drip. Which type of insulin should the nurse locate for the registered nurse to mix into the intravenous fluids?
- A. Isophane
- B. Glargine
- C. Regular
- D. Detemir
Correct Answer: C
Rationale: The correct insulin type for the nurse to mix into the intravenous fluids is regular insulin. In the scenario of diabetic ketoacidosis (DKA), rapid reduction of blood glucose levels is crucial. Regular insulin has a fast onset of action, making it suitable for intravenous administration to address the high blood sugar levels seen in DKA. Isophane, Glargine, and Detemir are not appropriate choices for intravenous administration in this emergency situation as they are intermediate-acting or long-acting insulins.
A 43-year-old female client who has had a thyroidectomy due to Grave's disease is prescribed a thyroid replacement hormone. Which signs and symptoms are associated with thyroid hormone toxicity and should be reported promptly to the health care provider?
- A. Tinnitus and dizziness
- B. Tachycardia and chest pain
- C. Dry skin and intolerance to cold
- D. Weight gain and increased appetite
Correct Answer: B
Rationale: The signs and symptoms of thyroid hormone toxicity, especially when the dosage is excessive, include tachycardia (rapid heart rate) and chest pain. These symptoms are indicative of hyperthyroidism, where the body receives an excessive amount of thyroid hormone. It is crucial to report these symptoms promptly to the healthcare provider to adjust the medication dosage and prevent potential complications.
A client with a diagnosis of generalized anxiety disorder is prescribed fluvoxamine. The nurse should instruct the client that this medication may have which potential side effect?
- A. Drowsiness
- B. Dry mouth
- C. Insomnia
- D. Headache
Correct Answer: A
Rationale: The correct answer is A: Drowsiness. Fluvoxamine is known to cause drowsiness as a potential side effect. Patients should be advised to avoid activities like driving that require alertness until they understand how the medication affects them. Dry mouth, insomnia, and headache are potential side effects of other medications used for anxiety disorders but are not typically associated with fluvoxamine.