A client with portosystemic encephalopathy is receiving oral lactulose (Chronulac) daily. The nurse assesses which of the following to determine medication effectiveness?
- A. Lung sounds
- B. Blood pressure
- C. Blood ammonia level
- D. Serum potassium level
Correct Answer: C
Rationale: In portosystemic encephalopathy, the liver's ability to detoxify ammonia is impaired, leading to elevated blood ammonia levels, which can cause neurological symptoms such as encephalopathy. Lactulose is given to reduce ammonia levels by promoting its excretion through the bowel. Therefore, assessing the blood ammonia level is crucial to determine the effectiveness of lactulose therapy in managing portosystemic encephalopathy.
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The clinic nurse is performing an admission assessment on a client. The nurse notes that the client is taking azelaic acid (Azelex). Because of the medication prescription, the nurse would suspect that the client is being treated for:
- A. Acne
- B. Eczema
- C. Hair loss
- D. Herpes simplex
Correct Answer: A
Rationale: Azelaic acid (Azelex) is a topical medication used to treat mild to moderate acne. It works by suppressing the growth of Propionibacterium acnes and decreasing the proliferation of keratinocytes in the skin. Therefore, if a client is prescribed azelaic acid, the nurse would suspect that the client is being treated for acne.
A client with diabetes mellitus visits a health care clinic. The client's diabetes mellitus was previously well controlled with daily glyburide (DiaBeta). However, the fasting blood glucose level has recently been in the range of 180 to 200 mg/dL. Which medication, if added to the client's regimen, may have contributed to the hyperglycemia?
- A. Prednisone
- B. Phenelzine (Nardil)
- C. Atenolol (Tenormin)
- D. Allopurinol (Zyloprim)
Correct Answer: A
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.
A client with angina pectoris is experiencing chest pain that radiates down the left arm. The nurse administers a sublingual nitroglycerin tablet to the client. The client's pain is unrelieved, and the nurse determines that the client needs another nitroglycerin tablet. Which of the following vital signs is most important for the nurse to check before administering the medication?
- A. Temperature
- B. Respirations
- C. Blood pressure
- D. Radial pulse rate
Correct Answer: C
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.
Alendronate (Fosamax) is prescribed for a client with osteoporosis. The client taking this medication is instructed to:
- A. Take the medication at bedtime.
- B. Take the medication in the morning with breakfast.
- C. Lie down for 30 minutes after taking the medication.
- D. Take the medication with a full glass of water after rising in the morning.
Correct Answer: D
Rationale: Alendronate (Fosamax) should be taken with a full glass of water after rising in the morning to prevent gastrointestinal side effects and increase absorption. Taking the medication with a full glass of water and in an upright position after waking up helps decrease the risk of esophageal irritation and enhances the drug's effectiveness by ensuring proper absorption in the gastrointestinal tract.
Atenolol hydrochloride (Tenormin) is prescribed for a hospitalized client. The nurse should perform which of the following as a priority action before administering the medication?
- A. Listen to the client's lung sounds.
- B. Check the client's blood pressure.
- C. Check the recent electrolyte levels.
- D. Assess the client for muscle weakness.
Correct Answer: B
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.