Nokea
A client with a history of osteoarthritis is prescribed ibuprofen. The nurse should instruct the client to take the medication:
- A. On an empty stomach to enhance absorption.
- B. With food to reduce gastrointestinal irritation.
- C. At bedtime to promote sleep.
- D. With a diuretic to reduce swelling.
Correct Answer: B
Rationale: Ibuprofen should be taken with food to minimize gastrointestinal irritation and reduce the risk of ulcers.
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A client at a follow-up appointment after having a miscarriage 2 weeks previously yells at the nurse, 'How could God do this to me? I've never done anything wrong.' Which of the following responses by the nurse would be most appropriate at this time?
- A. God can handle your anger. It's okay.'
- B. I know you are angry. It's so hard to lose your baby.'
- C. It's not God's fault. It was an accident.'
- D. You're a strong person. You will get through this.'
Correct Answer: B
Rationale: Acknowledging the client's anger and the difficulty of the loss validates their emotions and provides empathetic support, which is most appropriate in this situation. Option A may dismiss the client's feelings, C shifts focus inappropriately, and D assumes strength without addressing the emotional impact.
A client with a diagnosis of chronic obstructive pulmonary disease (COPD) is prescribed tiotropium (Spiriva). The nurse should instruct the client to:
- A. Use the inhaler as needed for shortness of breath.
- B. Rinse the mouth after using the inhaler.
- C. Shake the inhaler before use.
- D. Take two puffs twice daily.
Correct Answer: B
Rationale: Rinsing the mouth after using tiotropium prevents oral candidiasis, a common side effect of inhaled anticholinergics.
Immediately after the client receives an injection of bupivacaine (Marcaine), he becomes restless and nervous and reports a feeling of impending doom. Which of the following actions by the nurse is appropriate at this time?
- A. Ask the client to talk more about what he is feeling
- B. Reassure the client that it is normal to feel restless before a procedure
- C. Assess the client's vital signs
- D. Administer epinephrine
Correct Answer: C
Rationale: Restlessness, nervousness, and a feeling of impending doom after bupivacaine injection may indicate systemic toxicity or an allergic reaction, requiring immediate vital sign assessment to guide further action. Talking, reassurance, or administering epinephrine without assessment is premature.
A client with a history of anxiety is prescribed buspirone (Buspar). The nurse should instruct the client that:
- A. The medication may take 2–4 weeks to be effective.
- B. The medication should be taken with grapefruit juice.
- C. The medication should be stopped if anxiety resolves.
- D. The medication is taken as needed for anxiety.
Correct Answer: A
Rationale: Buspirone requires 2–4 weeks to achieve therapeutic effects, unlike as-needed anxiolytics.
You are asked by your supervisor to take photographs of the residents and their family members who are attending a holiday dinner and celebration at your long term care facility. What should you do?
- A. Take the photographs because these photographs are part of the holiday tradition at this facility
- B. Take the photographs because all of the residents are properly attired and in a dignified condition
- C. Refuse to take the photographs unless you have the consent of all to do so
- D. Refuse to take the photographs because this is not part of the nurse's role
Correct Answer: C
Rationale: Taking photographs without the explicit consent of all residents and family members violates their privacy rights under HIPAA . Consent must be obtained to ensure compliance with privacy regulations.