Nokea
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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When is the best time for a client to take a daily dose of prednisone?
- A. At noon
- B. At bedtime
- C. Early morning
- D. Anytime, at the same time each day
Correct Answer: C
Rationale: The correct time for a client to take a daily dose of prednisone is early morning. Corticosteroids like prednisone should be taken in the morning to mimic the body's natural hormone release pattern. This timing helps reduce the risk of disrupting the body's internal clock and minimizes the potential for insomnia or other sleep disturbances.
A client is prescribed phenytoin (Dilantin) for seizure control. Which statement by the client indicates an understanding of the medication?
- A. I should brush and floss my teeth regularly.
- B. I should take the medication with antacids.
- C. I can stop taking the medication once my seizures are controlled.
- D. I should avoid drinking milk while taking this medication.
Correct Answer: A
Rationale: The correct statement is 'I should brush and floss my teeth regularly.' Phenytoin (Dilantin) can cause gingival hyperplasia, so maintaining good oral hygiene is essential. Taking the medication with antacids can affect its absorption, so it should not be done. It is crucial not to stop taking the medication abruptly, even if seizures are controlled. There is no specific requirement to avoid milk while taking phenytoin (Dilantin).
A client who has begun taking fosinopril (Monopril) is very distressed, telling the nurse that he cannot taste food normally since beginning the medication 2 weeks ago. The nurse provides the best support to the client by:
- A. Telling the client not to take the medication with food
- B. Suggesting that the client taper the dose until taste returns to normal
- C. Informing the client that impaired taste is expected and generally disappears in 2 to 3 months
- D. Requesting that the health care provider (HCP) change the prescription to another brand of angiotensin-converting enzyme (ACE) inhibitor
Correct Answer: C
Rationale: The correct answer is to inform the client that impaired taste is an expected side effect of ACE inhibitors like fosinopril, such as Monopril, and typically resolves within 2 to 3 months. It is essential for the nurse to offer reassurance and education to the client about this common side effect to alleviate distress and encourage compliance with the medication regimen.
The client with acute myelocytic leukemia is being treated with busulfan (Myleran). Which laboratory value should the nurse specifically monitor during treatment with this medication?
- A. Clotting time
- B. Uric acid level
- C. Potassium level
- D. Blood glucose level
Correct Answer: B
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.
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.