A healthcare professional is caring for four clients who have Peptic Ulcer Disease. The healthcare professional should recognize Misoprostol is contraindicated for which of the following clients?
- A. A client who is pregnant
- B. A client who has osteoarthritis
- C. A client who has a kidney stone
- D. A client who has a urinary tract infection
Correct Answer: A
Rationale: Misoprostol is contraindicated in pregnancy as it can induce labor and potentially lead to harm to the fetus. Therefore, it should not be used in pregnant clients due to its uterotonic effects. For clients with osteoarthritis, kidney stone, or urinary tract infection, Misoprostol is not contraindicated specifically for these conditions.
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A client with Addison's disease is being admitted for a total hip arthroplasty. The client takes hydrocortisone for Addison's disease. What is the nurse's priority action?
- A. Administering a supplemental dose of hydrocortisone
- B. Instructing the client about coughing and deep breathing
- C. Collecting additional information from the client about his history of Addison's disease
- D. Inserting an indwelling urinary catheter
Correct Answer: A
Rationale: The nurse's priority in this situation is to administer a supplemental dose of hydrocortisone. Clients with Addison's disease taking hydrocortisone are at risk of acute adrenal insufficiency during times of stress such as surgery. Administering supplemental doses of hydrocortisone helps prevent acute adrenal insufficiency (adrenal crisis) in these situations, making it the priority action to ensure the client's safety. Instructing the client about coughing and deep breathing is important postoperatively but not the priority at this time. Collecting additional information about the client's history of Addison's disease is important but not the priority action before surgery. Inserting an indwelling urinary catheter is not the priority in this situation.
A child is prescribed Amoxicillin 20 mg/kg/day PO to be administered every 12 hr. The child weighs 44 lb. The available medication is amoxicillin suspension 250 mg/5 mL. How many mL should be given per dose?
- A. 4 mL
- B. 5 mL
- C. 6 mL
- D. 3 mL
Correct Answer: A
Rationale: To calculate the dosage per administration: Convert the weight to kg (44 lb / 2.2 lb/kg = 20 kg). Then, (20 mg/kg/day x 20 kg) / 2 (for every 12 hr dosing) = 200 mg per dose. (200 mg / 250 mg) x 5 mL = 4 mL per dose. Therefore, the nurse should administer 4 mL of amoxicillin suspension per dose. Choice B, 5 mL, is incorrect because the calculation shows that 4 mL is the correct dose. Choices C and D are also incorrect as they are not in line with the calculated dosage based on the weight of the child and the concentration of the medication.
A client is prescribed Omeprazole for managing heartburn. What information should the nurse include in the teaching?
- A. Take this medication at bedtime.
- B. This medication decreases the production of gastric acid.
- C. Take this medication 2 hours after eating.
- D. This medication can cause hyperkalemia.
Correct Answer: B
Rationale: The correct answer is B. The nurse should educate the client that Omeprazole works by reducing the production of gastric acid through inhibiting the enzyme responsible for its production. This action helps in managing heartburn and related symptoms effectively. Choice A is incorrect because Omeprazole is usually taken before eating. Choice C is incorrect as Omeprazole is typically taken before a meal. Choice D is unrelated to Omeprazole, as it is not associated with causing hyperkalemia.
When teaching a client with a prescription for long-term use of oral prednisone for chronic asthma, the nurse should instruct the client to monitor for which of the following adverse effects of this medication?
- A. Weight gain
- B. Nervousness
- C. Bradycardia
- D. Constipation
Correct Answer: A
Rationale: The correct answer is weight gain. Weight gain and fluid retention are common adverse effects of oral prednisone due to sodium and water retention. Patients on long-term prednisone therapy should be advised to monitor their weight closely and report any significant changes to their healthcare provider. Choice B, 'Nervousness,' is not typically associated with oral prednisone use. Choice C, 'Bradycardia,' refers to a slow heart rate, which is not a common adverse effect of prednisone. Choice D, 'Constipation,' is not a typical adverse effect of oral prednisone; instead, gastrointestinal disturbances like increased appetite or even peptic ulcer disease may occur.
A client has a new prescription for nitroglycerin sublingual tablets. Which of the following instructions should the nurse include?
- A. Take one tablet at the first sign of chest pain.
- B. If pain is not relieved, take another tablet in 10 minutes.
- C. You can take up to five tablets in 15 minutes.
- D. Swallow the tablet with water.
Correct Answer: A
Rationale: The correct instruction for a client with a new prescription for nitroglycerin sublingual tablets is to take one tablet at the first sign of chest pain. If the pain persists after 5 minutes, the client should call 911 and take a second tablet. Choice A is correct because taking one tablet at the onset of chest pain helps to relieve symptoms by dilating blood vessels and improving blood flow to the heart. Choices B and C are incorrect as they suggest taking multiple tablets without waiting for the initial dose to take effect, which can lead to hypotension and other adverse effects. Choice D is incorrect as nitroglycerin sublingual tablets should not be swallowed but instead placed under the tongue for rapid absorption.