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A client with Addison's disease is being admitted for a total hip arthroplasty. The client takes hydrocortisone. What is the nurse's priority action?
- A. Administering a supplemental dose of hydrocortisone
- B. Instructing the client about coughing and deep breathing
- C. Collecting additional information from the client about his history of Addison's disease
- D. Inserting an indwelling urinary catheter
Correct Answer: A
Rationale: The priority action for a client with Addison's disease undergoing surgery who takes hydrocortisone is to administer a supplemental dose of hydrocortisone. Acute adrenal insufficiency (adrenal crisis) is a significant risk during surgery due to the stress placed on the body. Supplemental doses help prevent acute adrenal insufficiency and ensure the client's safety during the surgical procedure. Instructing the client about coughing and deep breathing is important post-operatively but not the priority before surgery. Collecting additional information about the client's history of Addison's disease is relevant but not the priority action before surgery. Inserting an indwelling urinary catheter is not the priority action in this scenario.
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A client has a new prescription for Furosemide. Which of the following instructions should the nurse include?
- A. Take this medication at bedtime.
- B. Avoid eating foods high in potassium.
- C. Change positions slowly.
- D. Take this medication with meals.
Correct Answer: C
Rationale: The correct instruction to include when a client is prescribed Furosemide is to change positions slowly. Furosemide is a diuretic that can lead to orthostatic hypotension, causing dizziness and increasing the risk of falls. By advising the client to change positions slowly, the nurse helps prevent these adverse effects and ensures the client's safety. Option A is incorrect because Furosemide is usually taken in the morning to prevent disturbed sleep due to frequent urination. Option B is incorrect as Furosemide can cause potassium loss, so advising to avoid foods high in potassium would not be appropriate. Option D is incorrect because taking Furosemide with meals may increase the risk of side effects and decrease its effectiveness.
A client has a new prescription for Hydrochlorothiazide. Which of the following instructions should the nurse include?
- A. Take this medication in the morning.
- B. Consume potassium-rich foods.
- C. Take this medication with food.
- D. Monitor for signs of dehydration.
Correct Answer: D
Rationale: The correct answer is to monitor for signs of dehydration. Hydrochlorothiazide is a diuretic that can lead to fluid loss and dehydration. The client should be educated to watch for symptoms like dry mouth, increased thirst, weakness, dizziness, and decreased urine output. Prompt recognition of dehydration signs is crucial for timely intervention and prevention of complications. Choices A, B, and C are incorrect. Taking Hydrochlorothiazide in the morning is not a specific instruction for this medication. While potassium-rich foods can be important when taking certain medications, it is not the priority instruction for Hydrochlorothiazide. Taking this medication with food may help reduce stomach upset but is not the most critical instruction for a diuretic like Hydrochlorothiazide.
A healthcare provider is caring for four clients who have Peptic Ulcer Disease. The healthcare provider should recognize Misoprostol is contraindicated for which of the following clients?
- A. A client who is pregnant
- B. A client who has osteoarthritis
- C. A client who has a kidney stone
- D. A client who has a urinary tract infection
Correct Answer: A
Rationale: Misoprostol is contraindicated in pregnancy due to its potential to induce labor. It is used to prevent ulcers in patients taking nonsteroidal anti-inflammatory drugs and is not indicated for osteoarthritis, kidney stones, or urinary tract infections. Therefore, the correct answer is A. Misoprostol should not be used in pregnant individuals as it can cause uterine contractions and potentially harm the fetus. Choices B, C, and D are incorrect as Misoprostol is not contraindicated for clients with osteoarthritis, kidney stones, or urinary tract infections.
A client has a new prescription for Clopidogrel. Which of the following instructions should the nurse include?
- A. Take this medication with food.
- B. Avoid taking aspirin while on this medication.
- C. Avoid eating foods high in potassium.
- D. Take this medication at bedtime.
Correct Answer: B
Rationale: The correct answer is B: 'Avoid taking aspirin while on this medication.' Clopidogrel is an antiplatelet medication that can increase the risk of bleeding. Aspirin and other NSAIDs also affect platelet function and can further increase the risk of bleeding when combined with Clopidogrel. Therefore, it is important for the client to avoid taking aspirin while on this medication to reduce the risk of excessive bleeding. Choices A, C, and D are incorrect because there is no specific requirement to take Clopidogrel with food, avoid foods high in potassium, or take it at bedtime. The key instruction here is to avoid aspirin to prevent potential bleeding complications.
A nurse orienting a newly licensed nurse is reviewing the procedure for taking a telephone prescription. Which of the following statements should the nurse identify as an indication that the newly licensed nurse understands the process?
- A. A second nurse enters the prescription into the client's medical record.
- B. Another nurse should listen to the phone call.
- C. The provider can clarify the prescription when he signs the health record.
- D. I should omit the 'read back' if this is a one-time prescription.
Correct Answer: B
Rationale: The correct answer is B: 'Another nurse should listen to the phone call.' When taking a telephone prescription, having another nurse listen to the phone call is essential to prevent errors in communication. This process helps ensure accuracy and reduces the risk of misinterpretation. Choice A is incorrect because entering the prescription into the client's medical record is not related to verifying the accuracy of the telephone prescription. Choice C is incorrect as the provider clarifying the prescription upon signing the health record doesn't address the immediate need for verification during the phone call. Choice D is incorrect because the 'read back' is a crucial step in confirming the accuracy of all prescriptions, regardless of whether they are one-time or recurring.