Nokea
A client with a history of migraine headaches is prescribed sumatriptan (Imitrex). The nurse should instruct the client to:
- A. Take the medication at the onset of a migraine.
- B. Take the medication daily to prevent migraines.
- C. Avoid taking the medication with food.
- D. Stop the medication if nausea occurs.
Correct Answer: A
Rationale: Sumatriptan is most effective when taken at the onset of a migraine to abort the attack.
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Your client has a doctor's order for the antihistamine medication diphenhydramine for sleep. What should you do?
- A. Question the order because Benadryl is an antihistamine and not a sleeping medication.
- B. Refuse to give the Benadryl because this medication is a stimulant.
- C. Question the order because Benadryl is contraindicated when the client has a sleep inducement disorder.
- D. Give the Benadryl because sleep inducement is an accepted off label use of this medication.
Correct Answer: D
Rationale: Diphenhydramine (Benadryl) is commonly used off-label for sleep due to its sedative effects, making it an appropriate choice if ordered for this purpose.
The nurse should advise which of the following clients who is taking lithium to consult with the physician regarding a potential adjustment in lithium dosage?
- A. A client who continues work as a computer programmer.
- B. A client who attends college classes.
- C. A client who can now care for her children.
- D. A client who is beginning training for a tennis team.
Correct Answer: D
Rationale: Increased physical activity, such as tennis training, can lead to dehydration or electrolyte imbalances, which may affect lithium levels and increase toxicity risk, necessitating a dosage adjustment.
A client has been given a prescription to begin using nitroglycerin transdermal patches. The nurse instructs the client about this medication administration system and tells the client to expect which side effect?
- A. Sweating
- B. Headache
- C. Dry mouth
- D. Constipation
Correct Answer: B
Rationale: Nitroglycerin is a coronary vasodilator used in the management of coronary artery disease. A common side effect of this medication is an intense headache. Clients should be instructed about this side effect and that acetaminophen can be helpful in alleviating discomfort. The remaining options are not associated with the use of this medication.
When a breast-feeding mother reports experiencing nipple soreness, the nurse provides teaching regarding measures to relieve the soreness. Which statement by the mother indicates an understanding of the teaching?
- A. I need to avoid rotating breast-feeding positions so that the nipple will toughen.
- B. I need to stop nursing during the period of nipple soreness to allow the nipples to heal.
- C. I need to nurse less frequently and substitute a bottle feeding until the nipples become less sore.
- D. I need to position my infant with her ear, shoulder, and hip in straight alignment and place her stomach against me.
Correct Answer: D
Rationale: Comfort measures for nipple soreness include positioning the infant with the ear, shoulder, and hip in straight alignment and with the infant's stomach against the mother's. Additional measures include rotating breastfeeding positions, breaking suction with the little finger, nursing frequently, beginning feeding on the less sore nipple, not allowing the infant to chew on the nipple or to sleep holding the nipple in the mouth, and applying tea bags soaked in warm water to the nipple. The remaining options are incorrect statements.
The nurse is caring for a client who has just undergone a total hip replacement. Which of the following positions should the nurse avoid placing the client in?
- A. Supine with legs crossed.
- B. Semi-Fowler's position.
- C. Side-lying with a pillow between the legs.
- D. Supine with the legs abducted.
Correct Answer: A
Rationale: Crossing the legs post-hip replacement risks dislocation of the prosthesis and should be avoided.