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A client with a new diagnosis of myasthenia gravis is prescribed pyridostigmine (Mestinon). Which instruction should the nurse include in the client's teaching?
- A. Take the medication with food to prevent gastrointestinal upset.
- B. Take the medication 30 minutes before meals.
- C. Avoid dairy products while taking this medication.
- D. Take the medication at bedtime.
Correct Answer: B
Rationale: The correct answer is B: Take the medication 30 minutes before meals. Pyridostigmine is a cholinesterase inhibitor used to treat myasthenia gravis by improving muscle strength. Taking it before meals helps optimize its effects when muscle strength is needed the most during eating. Taking it with food (A) may delay absorption. Avoiding dairy products (C) is not necessary with pyridostigmine. Taking the medication at bedtime (D) may not be optimal for addressing muscle weakness during meal times.
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A client with type 1 diabetes mellitus is experiencing nausea and vomiting. What advice should the nurse give regarding insulin administration?
- A. Skip your insulin dose until you can eat.'
- B. Take your insulin as prescribed, but monitor your blood glucose closely.'
- C. Reduce your insulin dose by half.'
- D. Only take your long-acting insulin.'
Correct Answer: B
Rationale: The correct answer is B because skipping insulin can lead to dangerous complications like diabetic ketoacidosis. Taking insulin as prescribed ensures blood glucose control, preventing hyperglycemia. Monitoring blood glucose closely helps adjust doses accordingly. Choice A is incorrect as skipping insulin can be life-threatening. Choice C is incorrect as reducing insulin without proper monitoring can lead to unstable glucose levels. Choice D is incorrect as both long-acting and short-acting insulin are essential for managing type 1 diabetes.
A patient with hyperlipidemia is prescribed atorvastatin. What lab test should be monitored periodically to assess for adverse effects?
- A. Liver function tests
- B. Complete blood count
- C. Blood glucose levels
- D. Serum potassium
Correct Answer: A
Rationale: Step-by-step rationale:
1. Atorvastatin is a statin medication commonly known to potentially cause liver damage.
2. Monitoring liver function tests periodically helps assess for any liver abnormalities.
3. Elevated liver enzymes may indicate liver injury from atorvastatin.
4. Monitoring liver function tests allows for early detection and management of adverse effects.
Summary:
A: Monitoring liver function tests is crucial due to atorvastatin's potential hepatotoxicity.
B: Complete blood count is not typically affected by atorvastatin.
C: Blood glucose levels are not directly related to atorvastatin use.
D: Serum potassium is not specifically monitored for atorvastatin-related adverse effects.
A patient with gout is prescribed allopurinol. What should the nurse include in the patient teaching?
- A. Take the medication with food.
- B. Increase intake of high-purine foods.
- C. Limit fluid intake to 1 liter per day.
- D. Expect immediate pain relief.
Correct Answer: A
Rationale: The correct answer is A: Take the medication with food. Allopurinol can cause stomach upset, so taking it with food can help minimize gastrointestinal side effects. Taking it on an empty stomach may increase the risk of nausea or stomach pain. Choice B is incorrect because increasing high-purine foods can exacerbate gout symptoms. Choice C is incorrect because limiting fluid intake can lead to dehydration, which is not recommended for gout patients. Choice D is incorrect because allopurinol does not provide immediate pain relief; it works to lower uric acid levels over time to prevent gout attacks.
What is the primary action of a short-acting beta2-agonist (SABA) prescribed to a patient with an acute asthma exacerbation?
- A. Reduce inflammation
- B. Relieve bronchospasm
- C. Thin respiratory secretions
- D. Suppress cough
Correct Answer: B
Rationale: The correct answer is B: Relieve bronchospasm. Short-acting beta2-agonists (SABAs) like albuterol act by stimulating beta2 receptors in the airway smooth muscle, leading to bronchodilation and relieving bronchospasm. This helps to quickly open up the airways during an acute asthma exacerbation. Choice A is incorrect because SABAs do not directly reduce inflammation. Choice C is incorrect as SABAs do not affect respiratory secretions. Choice D is incorrect as SABAs do not suppress cough but rather target bronchospasm.
What instructions should the nurse give to a patient with cervical cancer who is planned to receive external-beam radiation to prevent complications from the effects of the radiation?
- A. Test all stools for the presence of blood.
- B. Maintain a high-residue, high-fiber diet.
- C. Clean the perianal area carefully after every bowel movement.
- D. Inspect the mouth and throat daily for the appearance of thrush.
Correct Answer: C
Rationale: The correct answer is C: Clean the perianal area carefully after every bowel movement. This is important to prevent skin breakdown and infection due to the potential side effect of radiation-induced diarrhea. By maintaining good hygiene in the perianal area, the patient can reduce the risk of complications such as skin irritation and infection.
Choice A is incorrect because testing stools for the presence of blood is not directly related to preventing complications from external-beam radiation.
Choice B is incorrect because while a high-residue, high-fiber diet may be beneficial for some cancer patients, it is not specifically recommended to prevent complications from radiation therapy in this case.
Choice D is incorrect because inspecting the mouth and throat daily for thrush is more relevant for patients receiving chemotherapy or immunosuppressive therapy, not specifically for those undergoing external-beam radiation.