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A client with amyotrophic lateral sclerosis (ALS) has been taking riluzole for two weeks. The nurse notes that the client remains weak with observable muscle atrophy. What action should the nurse take?
- A. Explain that the medication may take time to show improvement in symptoms
- B. Withhold the medication and notify the healthcare provider
- C. Advise the client to undergo liver function tests
- D. Document the assessment findings in the electronic health record
Correct Answer: D
Rationale: In this scenario, the nurse's priority is to document the assessment findings in the electronic health record. This action is crucial for maintaining an accurate record of the client's health status and can provide valuable information for the healthcare team. Withholding medication or advising additional tests should only be done after consulting with the healthcare provider based on the documented assessment findings.
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A client arrives to the emergency department experiencing diabetic ketoacidosis (DKA). The healthcare provider prescribes an insulin intravenous drip. Which type of insulin should the nurse locate for the registered nurse to mix into the intravenous fluids?
- A. Isophane
- B. Glargine
- C. Regular
- D. Detemir
Correct Answer: C
Rationale: The correct insulin type for the nurse to mix into the intravenous fluids is regular insulin. In the scenario of diabetic ketoacidosis (DKA), rapid reduction of blood glucose levels is crucial. Regular insulin has a fast onset of action, making it suitable for intravenous administration to address the high blood sugar levels seen in DKA. Isophane, Glargine, and Detemir are not appropriate choices for intravenous administration in this emergency situation as they are intermediate-acting or long-acting insulins.
A client who is prescribed sildenafil for pulmonary hypertension calls the clinic for advice. Which condition should the practical nurse notify the health care provider immediately and instruct the client to stop taking the medication?
- A. The client is experiencing vision and hearing loss.
- B. The client has an erection lasting longer than 2 hours.
- C. The client is complaining of nasal congestion.
- D. The client is complaining of feeling flushed.
Correct Answer: A
Rationale: The correct answer is A. If a client prescribed sildenafil for pulmonary hypertension experiences vision and/or hearing loss or an erection lasting more than 4 hours, the practical nurse should instruct the client to discontinue the medication immediately and notify the health care provider. These symptoms could indicate serious side effects that require prompt medical attention to prevent complications.
The nurse is caring for a patient with short-term persistent diarrhea. Which class of medication would the nurse anticipate giving?
- A. Lubricants
- B. Probiotics
- C. Adsorbents
- D. Anticholinergics
Correct Answer: B
Rationale: Probiotics are the correct choice in this scenario as they help restore normal gut flora, which can be effective in treating diarrhea by promoting a healthy balance of bacteria in the intestines. Lubricants are used to ease bowel movements, adsorbents work by binding to toxins in the gut, and anticholinergics are more commonly used for conditions like overactive bladder.
A client with asthma is prescribed fluticasone. The nurse should instruct the client to use this medication at which time?
- A. During an asthma attack
- B. Twice a day
- C. Once a day
- D. At night before bed
Correct Answer: C
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.
A client who is recovering from an appendectomy is receiving narcotics. Earlier, the nurse witnessed the client's family pushing the pain pump. What should the nurse implement?
- A. Check client's level of consciousness
- B. Instruct the family not to push the button
- C. Stop the client's basal infusion
- D. Administer a narcotic reversal medication
Correct Answer: B
Rationale: Instructing the family not to push the button is necessary to prevent the client from receiving an excessive amount of narcotics, ensuring the safe and appropriate use of the pain pump. Educating the family on the proper use of the pump helps maintain the client's pain management within prescribed limits and prevents accidental overdosing.