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A client with a history of anaphylactic reaction to penicillin receives a prescription for cephalexin 500 mg PO twice daily. Which action should the nurse take?
- A. Administer the medication as prescribed.
- B. Monitor the client for a rash or hives.
- C. Contact the healthcare provider.
- D. Give with prescribed antihistamine.
Correct Answer: B
Rationale: Cephalexin may cause cross-reactivity in penicillin-allergic clients, so monitoring for allergic reactions like rash or hives is critical. Administering without monitoring, contacting the provider immediately, or giving antihistamines prophylactically are less appropriate.
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A client with chronic asthma receives a prescription for montelukast, a leukotriene modifier. Which statement by the client indicates to the nurse that medication teaching was effective?
- A. I should take this medication only when I am having an asthma attack.
- B. I will not need to use my inhalers twice a day when I start this medicine.
- C. This medication will stop an asthma attack immediately.
- D. I will take the tablet every evening to control my asthma.
Correct Answer: D
Rationale: Montelukast is a maintenance medication taken regularly (often in the evening) to control asthma. It is not for acute attacks or to replace inhalers, indicating the client understands its role.
A client who experiences migraine headaches reports having fewer headaches since using the herbal remedy feverfew. Which information is most important for the nurse to include in a teaching plan for this client?
- A. Increased anxiety and nervousness have been reported by those taking feverfew.
- B. Those with allergies to chamomile, ragweed, or yarrow should not take feverfew.
- C. Abdominal pain, gas, nausea, vomiting, and diarrhea can occur when taking feverfew.
- D. Feverfew may interact with aspirin or nonsteroidal anti-inflammatory drugs (NSAIDs).
Correct Answer: B
Rationale: Feverfew can cause allergic reactions in individuals allergic to chamomile, ragweed, or yarrow, making this critical to prevent serious reactions. Anxiety, GI effects, or NSAID interactions are less urgent.
A male client who has been taking a high dose of a nonsteroidal antiinflammatory drug (NSAID) comes to the clinic reporting gastric pain and blood in his stool. The healthcare provider discontinues the NSAIDs and prescribes esomeprazole. Which information should the nurse include in this client's teaching plan?
- A. Once pain subsides, NSAID therapy can be resumed.
- B. Resume a diet that consists of milk, cream, and bland foods.
- C. Notify the healthcare provider of the passage of black stools.
- D. Call the clinic if diarrhea or headache occur when taking esomeprazole.
Correct Answer: C
Rationale: Black stools indicate potential gastrointestinal bleeding, a serious NSAID complication, requiring immediate provider notification. Resuming NSAIDs risks further damage, bland diets are outdated, and diarrhea/headache are less urgent.
A female client with mild depression reports to the nurse recently starting St. John's wort. Which information provided by the client requires further instruction?
- A. Hard candy can be used for a dry mouth.
- B. Insomnia may occur while taking the medication.
- C. Another form of contraception is not needed.
- D. Sensitivity to the sun can develop.
Correct Answer: C
Rationale: St. John's wort reduces oral contraceptive effectiveness, necessitating additional contraception. Dry mouth relief, insomnia, and photosensitivity are correct understandings.
According to the information gathered in the nurse's assessment, the nurse should prepare to give the client [Dropdown 1] and [Dropdown 2].
- A. Insulin glargine
- B. A snack
- C. Glucagon
- D. Ceftriaxone
- E. Juice
- F. A glass of Water
Correct Answer: A,B
Rationale: A blood glucose of 279 mg/dL requires insulin glargine for correction, and a snack prevents hypoglycemia post-insulin.