Nokea
A female client with mild depression reports to the nurse recently starting St. John's wort. Which information provided by the client requires further instruction?
- A. Hard candy can be used for a dry mouth.
- B. Insomnia may occur while taking the medication.
- C. Another form of contraception is not needed.
- D. Sensitivity to the sun can develop.
Correct Answer: C
Rationale: St. John's wort reduces oral contraceptive effectiveness, necessitating additional contraception. Dry mouth relief, insomnia, and photosensitivity are correct understandings.
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Based on a client's serum digoxin level, the client is diagnosed with digoxin toxicity. Which action should the nurse expect to implement?
- A. Give digoxin by another route to slow absorption.
- B. Begin cardioversion to stabilize heart rhythm.
- C. Administer potassium to stabilize the heart rate.
- D. Check acid-base and electrolyte values.
Correct Answer: D
Rationale: Checking acid-base and electrolyte values is critical to manage digoxin toxicity, as imbalances like hypokalemia exacerbate toxicity. Changing routes, cardioversion, or potassium administration are not immediate actions without further assessment.
A client with a history of chronic obstructive pulmonary disease (COPD) receives a new prescription for an ipratropium inhaler. Which action indicates to the nurse that additional teaching is needed?
- A. Stores the medication at room temperature.
- B. Primes the inhaler with 7 pumps.
- C. Attaches spacer device to the inhaler.
- D. Rinses the mouth after each use.
Correct Answer: B
Rationale: Priming an ipratropium inhaler with 7 pumps is excessive; typically, 2–3 pumps are needed if unused for a period. Room temperature storage, spacer use, and mouth rinsing are correct practices.
A client is receiving miotics for the treatment of open-angle glaucoma. The nurse determines that a priority nursing problem is 'risk for injury.' This nursing problem is based on which etiology?
- A. Increased frequency of lacrimation.
- B. Decreased night vision.
- C. Increased sensitivity to light.
- D. Diminished color perception.
Correct Answer: B
Rationale: Miotics constrict the pupil, reducing night vision and increasing injury risk in low-light conditions. Lacrimation, photophobia, and color perception changes are less directly linked to injury risk.
A female client who is starting a new prescription for doxycycline hyclate tells the nurse that she takes birth control pills. Which action should the nurse take?
- A. Instruct the client to take the two medications at least two hours apart.
- B. Advise the client that the birth control pills will be less effective while taking doxycycline hyclate.
- C. Notify the healthcare provider of the contraindication to tetracyclines.
- D. Encourage the client to stop taking birth control pills until she has finished taking all the doxycycline hyclate.
Correct Answer: B
Rationale: Doxycycline can reduce birth control pill effectiveness, requiring additional contraception. Timing separation, contraindication notification, or stopping birth control are incorrect actions.
The nurse is caring for a client with atrial fibrillation who receives a prescription for warfarin. The international normalized ratio (INR) is 2.8. Which action should the nurse take?
- A. Obtain another blood sample.
- B. Give the next scheduled dose.
- C. Monitor for signs of bleeding.
- D. Notify the healthcare provider.
Correct Answer: C
Rationale: An INR of 2.8 is within the therapeutic range for atrial fibrillation, but monitoring for bleeding is critical as a routine precaution. Repeating the sample, giving the dose, or notifying the provider are less immediate.