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A client with chronic obstructive pulmonary disease (COPD) is prescribed tiotropium (Spiriva). Which instruction should the nurse include in the teaching plan?
- A. Use the medication as a rescue inhaler.
- B. Rinse your mouth after using the inhaler.
- C. Take the medication on an empty stomach.
- D. Take the medication with a full glass of water.
Correct Answer: B
Rationale: Tiotropium (Spiriva) is not a rescue inhaler but a maintenance medication for COPD. The correct instruction for the nurse to include in the teaching plan is to advise the client to rinse their mouth after using the inhaler. This practice helps prevent dry mouth and throat irritation, common side effects of tiotropium. There are no specific recommendations to take tiotropium on an empty stomach or with a full glass of water.
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The client with small cell lung cancer is being treated with etoposide (VePesid). The nurse assisting in caring for the client during its administration understands that which side effect is specifically associated with this medication?
- A. Alopecia
- B. Chest pain
- C. Pulmonary fibrosis
- D. Orthostatic hypotension
Correct Answer: D
Rationale: The correct answer is 'D: Orthostatic hypotension.' Etoposide is associated with orthostatic hypotension, a sudden drop in blood pressure that can occur when transitioning from lying down to standing up. It is important for the nurse to monitor the client's blood pressure during the infusion to detect and manage this potential side effect.
The client has been taking omeprazole (Prilosec) for 4 weeks. The ambulatory care nurse evaluates that the client is receiving the optimal intended effect of the medication if the client reports the absence of which symptom?
- A. Diarrhea
- B. Heartburn
- C. Flatulence
- D. Constipation
Correct Answer: B
Rationale: Omeprazole, a proton pump inhibitor, is used as an antiulcer agent to reduce gastric acid secretion. The optimal intended effect of omeprazole is the relief of pain and discomfort associated with gastric irritation, commonly referred to as heartburn. Therefore, the absence of heartburn indicates that the medication is working effectively in managing the client's gastric condition.
Salicylic acid is prescribed for a client with a diagnosis of psoriasis. The nurse monitors the client, knowing that which of the following would indicate the presence of systemic toxicity from this medication?
- A. Tinnitus
- B. Diarrhea
- C. Constipation
- D. Decreased respirations
Correct Answer: A
Rationale: The correct answer is A: Tinnitus. Salicylic acid can lead to systemic toxicity, known as salicylism, which may manifest with symptoms like tinnitus, dizziness, hyperventilation, and mental disturbances. Tinnitus is a common early sign of salicylism and should be monitored closely by the nurse to prevent further complications.
A healthcare professional is planning to administer amlodipine (Norvasc) to a client. The healthcare professional plans to check which of the following before giving the medication?
- A. Respiratory rate
- B. Blood pressure and heart rate
- C. Heart rate and respiratory rate
- D. Level of consciousness and blood pressure
Correct Answer: B
Rationale: Before administering amlodipine, it is important to check the client's blood pressure and heart rate. Amlodipine is known to lower blood pressure and heart rate as part of its mechanism of action. Monitoring these vital signs helps ensure the safety of the client and allows for appropriate assessment of the medication's effects post-administration.
Phenazopyridine hydrochloride (Pyridium) is prescribed for a client for symptomatic relief of pain resulting from a lower urinary tract infection. The nurse reinforces to the client:
- A. To take the medication after meals
- B. To take the medication before meals
- C. To discontinue the medication if a headache occurs
- D. That a reddish-orange discoloration of the urine may occur
Correct Answer: D
Rationale: The nurse should instruct the client that a reddish-orange discoloration of urine may occur. The nurse should also educate the client that this discoloration can stain fabric. It is recommended to take the medication after meals to reduce the possibility of gastrointestinal upset. While a headache is an occasional side effect of the medication, it does not warrant discontinuation of the medication.