Nokea
A client with a diagnosis of gout is prescribed allopurinol (Zyloprim). The nurse should instruct the client to:
- A. Take the medication with food to reduce stomach upset.
- B. Avoid drinking alcohol.
- C. Limit fluid intake.
- D. Take the medication at bedtime only.
Correct Answer: A,B
Rationale: Taking allopurinol with food reduces gastrointestinal upset, and avoiding alcohol prevents uric acid buildup.
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A child diagnosed with tinea is being treated with griseofulvin (Grifulvin V). Which of the following instructions should the nurse give to the parents?
- A. Give the medication before a meal
- B. Have the child avoid intense sunlight
- C. Give the medication for 10 days
- D. Encourage increased fluid intake
Correct Answer: B
Rationale: Griseofulvin increases photosensitivity, so avoiding intense sunlight is critical. It is typically taken with food, requires weeks of treatment, and fluid intake is not specifically needed.
The nurse is caring for a client with a history of multiple sclerosis. Which of the following interventions should be included in the plan of care?
- A. Encourage daily exercise.
- B. Limit fluid intake.
- C. Provide a high-fat diet.
- D. Restrict social activities.
Correct Answer: A
Rationale: Daily exercise helps maintain mobility and strength in multiple sclerosis.
A client is scheduled for a colonoscopy. Which of the following instructions should the nurse include in the pre-procedure teaching?
- A. Avoid solid foods for 24 hours before the procedure.
- B. Take all regular medications the morning of the procedure.
- C. Expect to be sedated during the procedure.
- D. Plan to stay overnight in the hospital.
Correct Answer: A, C
Rationale: Clear liquid diet for 24 hours prevents residue, and sedation is common during colonoscopy. Regular medications may need adjustment, and overnight stays are not typical.
Which of the following patient care tasks is coupled with the appropriate member of the nursing care team in terms of their legal scope of practice?
- A. An unlicensed staff member who has been 'certified' by the employing agency to monitor telemetry: Monitoring cardiac telemetry
- B. An unlicensed assistive staff member like a nursing assistant who has been 'certified' by the employing agency to insert a urinary catheter: Inserting a urinary catheter
- C. A licensed practical nurse: The circulating nurse in the perioperative area
- D. A licensed practical nurse: The first assistant in the perioperative area
Correct Answer: A
Rationale: Monitoring cardiac telemetry is within the scope of practice for unlicensed staff who are specifically trained and certified by the employing agency. Inserting a urinary catheter typically requires a higher level of licensure (e.g., LPN or RN), and LPNs are not typically authorized to serve as circulating nurses or first assistants in the perioperative area, as these roles require advanced training or RN licensure.
After abdominal surgery, a client has an order for meperidine (Demerol) I.M. 100 mg every 3 to 4 hours and acetaminophen (Tylenol) with codeine 30 mg. The client has been taking meperidine every 4 hours for the past 48 hours, but she tells the nurse that the meperidine is no longer lasting 4 hours and she needs to have it every 3 hours. Which of the following nursing actions is most appropriate?
- A. Realizing that the client is developing tolerance to the meperidine, the nurse administers the meperidine every 3 hours.
- B. The nurse urges the client to take the acetaminophen with codeine to prevent addiction to the meperidine.
- C. The nurse requests an order from the physician to change the dose to an equianalgesic dose of morphine.
- D. The nurse encourages the client to do relaxation exercises to provide distraction from the pain.
Correct Answer: C
Rationale: Increasing frequency suggests tolerance; switching to an equianalgesic dose of morphine may provide better pain control without escalating doses.