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A female patient with multiple sclerosis reports less fatigue and improved memory since she started using the herbal supplement, ginkgo biloba. What is the most important information for the nurse to include in the teaching plan for this patient?
- A. Nausea and diarrhea can occur when using this supplement.
- B. Ginkgo biloba use should be limited and not taken during pregnancy.
- C. Aspirin and non-steroidal anti-inflammatory drugs interact with ginkgo.
- D. Anxiety and headaches increase with the use of ginkgo biloba.
Correct Answer: C
Rationale: This question is identical to Question 39. Ginkgo biloba’s interaction with aspirin/NSAIDs (C) increases bleeding risk, a critical teaching point. Other side effects (A, D) and pregnancy limits (B) are less urgent. Note: Duplicate question; consider removing.
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A client taking atorvastatin has an increased serum creatine phosphokinase (CK) level. What should the nurse assess the client for?
- A. Excessive bruising.
- B. Peripheral edema.
- C. Muscle tenderness.
- D. Nausea and vomiting.
Correct Answer: C
Rationale: Elevated CK with atorvastatin indicates possible myopathy, causing muscle tenderness (C). Bruising (A) is unrelated to CK. Edema (B) suggests other causes. Nausea/vomiting (D) are gastrointestinal side effects, not linked to CK.
The nurse administers naloxone to a patient with opioid-induced respiratory depression. An hour later, the nurse finds the patient has a respiratory rate of 4 breaths/minute, oxygen saturation of 75%, and is unresponsive. What action should the nurse take?
- A. Administer a second dose of naloxone.
- B. Prepare to assist with chest tube insertion.
- C. Determine Glasgow Coma Scale score.
- D. Initiate cardiopulmonary resuscitation (CPR).
Correct Answer: D
Rationale: Severe respiratory depression (4 breaths/min), hypoxia (75% SpO₂), and unresponsiveness require immediate CPR (D) to restore circulation/oxygenation. A second naloxone dose (A) may be needed but is secondary. Chest tubes (B) are irrelevant. Glasgow scoring (C) delays critical intervention.
An adult patient at an outpatient clinic has been prescribed the antibiotic tetracycline HCl. What instructions should the nurse include in the patient’s teaching plan?
- A. Consume with milk or antacids to prevent gastrointestinal irritation.
- B. Protect your skin from sunlight while on this medication.
- C. Enhance gastrointestinal absorption by taking with orange juice.
- D. Return to the clinic weekly for serum drug level checks.
Correct Answer: B
Rationale: This question is identical to Question 9. Tetracycline increases photosensitivity, requiring sun protection (B). Milk/antacids (A) and orange juice (C) impair absorption. Weekly drug checks (D) are unnecessary. Note: Duplicate question; consider removing.
Rivastigmine, a cholinesterase inhibitor, is prescribed for a female patient with early-stage Alzheimer’s Disease. The patient’s daughter tells the nurse that she plans to start administering the drug when her mother’s symptoms worsen, hoping to avoid nursing home placement. How should the nurse respond?
- A. Affirm the decision to use the medication when the symptoms start to worsen.
- B. Explain that the drug should be used early in the disease process.
- C. Assess the patient’s current mental status before deciding to support the decision.
- D. Confirm that the daughter is aware of the progressive nature of the disease.
Correct Answer: B
Rationale: Rivastigmine is most effective early in Alzheimer’s (B) to slow symptom progression. Delaying until worsening (A) reduces benefits. Mental status assessment (C) informs but doesn’t guide timing. Discussing disease progression (D) is secondary to medication timing.
The nurse is preparing to administer a scheduled dose of labetalol orally to a client with hypertension. The client’s vital signs are temperature 99° F (37.2 C), heart rate 48 beats/minute, respirations 16 breaths/minute, and blood pressure (BP) 150/90 mm Hg. What action should the nurse take?
- A. Withhold the scheduled dose and notify the healthcare provider.
- B. Administer the dose and monitor the client’s BP regularly.
- C. Assess for orthostatic hypotension before administering the dose.
- D. Apply a telemetry monitor before administering the dose.
Correct Answer: A
Rationale: Labetalol, a beta-blocker, can worsen bradycardia (heart rate 48 bpm). Withholding the dose and notifying the provider (A) is safest. Administering (B) risks exacerbating bradycardia. Orthostatic hypotension assessment (C) and telemetry (D) are secondary.