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A client with peptic ulcer disease is prescribed ranitidine (Zantac). Which statement by the client indicates the need for further teaching?
- A. I will take this medication at bedtime.
- B. I need to avoid smoking while taking this medication.
- C. I should take this medication with meals.
- D. This medication will help reduce stomach acid.
Correct Answer: C
Rationale: Rationale:
C is the correct answer. Ranitidine is usually taken on an empty stomach to maximize its effectiveness in reducing stomach acid production. Therefore, taking it with meals would decrease its efficacy. A, B, and D are incorrect because taking ranitidine at bedtime is common practice, smoking can worsen ulcer symptoms, and ranitidine does indeed reduce stomach acid.
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The healthcare provider prescribes 15 mg/kg of Streptomycin for an infant weighing 4 pounds. The drug is diluted in 25 ml of D5W to run over 8 hours. How much Streptomycin will the infant receive?
- A. 9 mg
- B. 18 mg
- C. 27 mg
- D. 36 mg
Correct Answer: A
Rationale: To calculate the dose of Streptomycin, we first need to convert the infant's weight from pounds to kg (4 lbs = 1.81 kg). Then, we multiply the weight in kg by the prescribed dose (15 mg/kg) to get the total dose (1.81 kg * 15 mg/kg = 27.15 mg). Since the drug is diluted in 25 ml of D5W, the infant will receive 27.15 mg in 25 ml solution. To find how much Streptomycin the infant actually receives, we need to calculate the amount in 1 ml (27.15 mg / 25 ml = 1.086 mg/ml). Finally, to determine how much the infant will receive over 8 hours, we multiply the concentration by the infusion rate (1.086 mg/ml * 25 ml * 8 hours = 217.2 mg). Therefore, the correct answer is A: 9 mg, as it represents the amount
A patient with type 2 diabetes is prescribed metformin. What instruction should the nurse provide regarding this medication?
- A. Take the medication on an empty stomach.
- B. Monitor for signs of hypoglycemia.
- C. Take the medication with meals.
- D. Increase intake of simple carbohydrates.
Correct Answer: C
Rationale: Step-by-step rationale for choice C:
1. Metformin can cause gastrointestinal side effects.
2. Taking it with meals helps reduce stomach upset.
3. It also helps in better absorption and effectiveness.
4. Therefore, the nurse should instruct the patient to take metformin with meals.
Summary of other choices:
A: Taking on an empty stomach can worsen gastrointestinal side effects.
B: Metformin doesn't typically cause hypoglycemia.
D: Increasing simple carbohydrates can counteract the effects of metformin.
A client with heart failure is receiving intravenous furosemide (Lasix). Which assessment finding indicates that the medication is having the desired effect?
- A. Decreased peripheral edema.
- B. Elevated blood pressure.
- C. Increased heart rate.
- D. Decreased urine output.
Correct Answer: A
Rationale: The correct answer is A: Decreased peripheral edema. Furosemide is a diuretic that helps to remove excess fluid from the body, which can reduce peripheral edema in patients with heart failure. This indicates that the medication is effectively reducing fluid overload in the body. Elevated blood pressure (choice B) would not be an expected outcome of furosemide use. Increased heart rate (choice C) is not a direct effect of furosemide and can indicate worsening heart failure. Decreased urine output (choice D) would be an adverse effect of furosemide and would indicate the medication is not working as intended.
While assessing a client with preeclampsia who is receiving magnesium sulfate, the nurse notes her deep tendon reflexes are 1+, respiratory rate is 12 breaths/minute, urinary output is 90 ml in 4 hours, and magnesium sulfate level is 9 mg/dl. What intervention should the nurse implement based on these findings?
- A. Continue the magnesium sulfate infusion as prescribed.
- B. Decrease the magnesium sulfate infusion by one-half.
- C. Stop the magnesium sulfate infusion immediately.
- D. Administer calcium gluconate immediately.
Correct Answer: C
Rationale: The correct answer is C: Stop the magnesium sulfate infusion immediately. The client is showing signs of magnesium toxicity, as evidenced by decreased deep tendon reflexes, bradypnea (respiratory rate of 12 breaths/minute), oliguria (urinary output of 90 ml in 4 hours), and elevated magnesium sulfate level of 9 mg/dl. Stopping the infusion is crucial to prevent further complications such as respiratory depression, cardiac arrest, and central nervous system depression. Continuing the infusion (choice A) would worsen the toxicity. Decreasing the infusion (choice B) may not be sufficient to address the toxicity. Administering calcium gluconate (choice D) is not the immediate priority; stopping the magnesium sulfate infusion is essential to prevent further harm.
After performing a paracentesis on a client with ascites, 3 liters of fluid are removed. Which assessment parameter is most critical for the nurse to monitor following the procedure?
- A. Pedal pulses.
- B. Breath sounds.
- C. Gag reflex.
- D. Vital signs.
Correct Answer: D
Rationale: The correct answer is D: Vital signs. After paracentesis, monitoring vital signs is crucial as fluid removal can lead to changes in blood pressure, heart rate, and overall fluid balance. Hypotension or tachycardia may indicate hypovolemia or shock. Pedal pulses (A) are important but not as critical post-paracentesis. Breath sounds (B) are important for respiratory assessment but not directly related to fluid removal. Gag reflex (C) is unrelated to paracentesis and not a priority post-procedure.