Nokea
A client with bi-polar disorder is taking lithium (Lithane). What should the nurse emphasize when teaching about this medication?
- A. Take the medication before meals
- B. Maintain adequate daily salt intake
- C. Reduce fluid intake to minimize diuresis
- D. Use antacids to prevent heartburn
Correct Answer: B
Rationale: Maintain adequate daily salt intake. Salt intake affects fluid volume, which can affect lithium (Lithane) levels; therefore, maintaining adequate salt intake is advised.
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The HCP ordered an angiotensin-converting enzyme (ACE) inhibitor for the client diagnosed with a myocardial infarction. Which statement best explains the rationale for administering this medication to this client?
- A. It will help prevent the development of congestive heart failure.
- B. This medication will help decrease the client's blood pressure.
- C. ACE inhibitors increase the contractility of the heart muscle.
- D. They will help decrease the development of atherosclerosis.
Correct Answer: A
Rationale: ACE inhibitors reduce afterload and prevent ventricular remodeling, lowering CHF risk post-MI, per ACC/AHA guidelines. BP, contractility, or atherosclerosis are secondary.
The client diagnosed with asthma is prescribed the mast cell inhibitor cromolyn. Which statement by the client indicates the need for further teaching?
- A. I will take two puffs of my inhaler before I exercise.
- B. I will rinse my mouth with water after taking the medication.
- C. After inhaling the medication, I will hold my breath for 10 seconds.
- D. When I start to wheeze, I will use my inhaler immediately.
Correct Answer: D
Rationale: Cromolyn is a prophylactic, not rescue, medication for asthma; using it during wheezing indicates misunderstanding. Pre-exercise use, breath-holding, and rinsing (though less critical) are correct.
A newly admitted client has a diagnosis of depression. She complains of 'twitching muscles' and a 'racing heart', and states she stopped taking Zoloft a few days ago because it was not helping her depression. Instead, she began to take her partner's Parnate. The nurse should immediately assess for which of these adverse reactions?
- A. Pulmonary edema
- B. Atrial fibrillation
- C. Mental status changes
- D. Muscle weakness
Correct Answer: C
Rationale: Mental status changes. Use of serotonergic agents may result in Serotonin Syndrome with confusion, nausea, palpitations, increased muscle tone with twitching muscles, and agitation. Serotonin syndrome is most often reported in patients taking 2 or more medications that increase CNS serotonin levels by different mechanisms. The most common drug combinations associated with serotonin syndrome involve the MAOIs, SSRIs, and the tricyclic antidepressants.
A nurse is assigned to perform well-child assessments at a day care center. A staff member interrupts the examinations to ask for assistance. They find a crying 3 year-old child on the floor with mouth wide open and gums bleeding. Two unlabeled open bottles lie nearby. The nurse's first action should be
- A. call the poison control center, then 911
- B. administer syrup of Ipecac to induce vomiting
- C. give the child milk to coat her stomach
- D. ask the staff about the contents of the bottles
Correct Answer: D
Rationale: ask the staff about the contents of the bottles. The nurse needs to assess what the child ingested before determining the next action. Once the substance is identified, the poison control center and emergency response team should be called.
An 80 year-old client is admitted with a diagnosis of malnutrition. In addition to physical assessments, which of the following lab tests should be closely monitored?
- A. Urine protein
- B. Urine creatinine
- C. Serum calcium
- D. Serum albumin
Correct Answer: D
Rationale: Serum albumin. Serum albumin is a valuable indicator of protein deficiency and, later, nutritional status in adults. A normal reading for an elder's serum albumin is between 3.0-5.0 g/dl.