Nokea
A client who is receiving pregabalin for fibromyalgia complains of tremors in the hands. Which action should the nurse implement?
- A. Notify the healthcare provider.
- B. Administer a PRN dose of an antianxiety drug.
- C. Obtain orthostatic blood pressure readings.
- D. Collect a capillary glucose level.
Correct Answer: A
Rationale: Tremors are a potential side effect of pregabalin, warranting notification of the healthcare provider for possible dose adjustment. Antianxiety drugs, blood pressure readings, or glucose levels are not directly related to addressing pregabalin-induced tremors.
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Ferrous sulfate elixir is prescribed for a client with iron deficiency anemia. Which instruction should the nurse provide this client about taking the liquid medication?
- A. Use a straw to ingest.
- B. Swallow undiluted.
- C. Mix with an antacid.
- D. Take with a glass of milk.
Correct Answer: A
Rationale: Using a straw prevents tooth staining from ferrous sulfate. Undiluted swallowing risks staining, antacids reduce absorption, and milk inhibits iron absorption due to calcium.
A young adult female client who is planning to become pregnant asks the nurse if she can continue taking isotretinoin for cystic acne. Which information is most important for the nurse to provide this client?
- A. Breastfeeding is not recommended while taking this medication.
- B. Do not take multiple vitamins that contain vitamin A while taking this drug.
- C. Baseline liver function results must be obtained during therapy.
- D. Discontinue this medication one month before attempting to conceive.
Correct Answer: D
Rationale: Isotretinoin is highly teratogenic, requiring discontinuation at least one month before conception to prevent birth defects. Breastfeeding, vitamin A, and liver monitoring are secondary concerns.
History and physical
The client is a 26-year-old female with acute appendicitis. She has a 12 year history of type 1 diabetes mellitus and no other significant medical history. The appendectomy was completed without issue, and the client will be admitted to the surgical floor to recover.
Nurses notes
0730
Admitted the client. She is awake and alert. She rates her pain 2 on a 0 to 10 pain scale. Her pulses are equal bilaterally. Heart rate is 76 beats/minute, normal sinus rhythm. Her oxygen saturation is 100% on room air. She has a gauze dressing over her surgical site, which is clean and dry. Her temperature is 98.5° F (37.0° C) orally. She urinated 50 mL upon arrival in the unit and is reporting she
Lab results
Blood glucose 279mg/dl
Flowsheet
0745
2 units insulin lispro given.
1800
12 units insulin glargine given.
Orders
0730
• Admit to the surgical floor
• Dextrose 5% and 0.9% sodium chloride IV to infuse at 125 mL/hr
-Advance diet as tolerated
• Insulin glargine 12 units SUBQ every 24 hours
. Ceftriaxone 2 gram IV piggy back (IVPB) every 24 hours for 3 days, first dose given in surgery
Choose the most likely options for the information missing from the statement(s) by selecting from the lists of options provided. The nurse should expect for the insulin glargine to start working in ------------------ and to continue working for---------------------------.
- A. 2 hours
- B. 24 hours
- C. 6 hours
- D. 30 minutes
- E. 8 hours
Correct Answer: A,B
Rationale: Insulin glargine starts working in about 2 hours and lasts approximately 24 hours, providing steady basal insulin.
The nurse is providing discharge instructions for a client with metastatic cancer who is prescribed morphine for bone pain. Which information from the client indicates to the nurse an understanding of the medication?
- A. Observe bowel movement pattern and take a stool softener.
- B. Watch for signs of agitation and record any insomnia.
- C. Take the benzodiazepine at the same time as taking the morphine.
- D. Do not drink grapefruit juice after taking morphine.
Correct Answer: A
Rationale: Morphine causes constipation, so monitoring bowel movements and using a stool softener demonstrates understanding. Agitation/insomnia, benzodiazepine timing, and grapefruit juice are not primary concerns.
A client is receiving tamsulosin, an alpha-adrenergic blocking agent, for the management of urinary retention due to benign prostatic hyperplasia (BPH). Which instruction is most important for the nurse to provide?
- A. Reduce daily fluid intake.
- B. Stand and sit up slowly.
- C. Take the medication early in the day.
- D. Use a twice-a-week dosing schedule.
Correct Answer: B
Rationale: Tamsulosin may cause orthostatic hypotension, so standing and sitting slowly prevents dizziness or falls. Fluid reduction, early dosing, or twice-weekly schedules are incorrect for tamsulosin.