Nokea
A nurse is caring for a client who has a new prescription for tamoxifen. The nurse should recognize that tamoxifen has which of the following therapeutic effects?
- A. Antiestrogenic
- B. Antimicrobial
- C. Androgenic
- D. Anti-inflammatory
Correct Answer: A
Rationale: Tamoxifen is an antiestrogen medication used primarily in the treatment and prevention of breast cancer. It works by blocking the effects of estrogen in the breast tissue, thereby acting as an antiestrogenic agent. This makes choice A the correct answer. Choice B, antimicrobial, is incorrect as tamoxifen does not possess antimicrobial properties and is not used to treat infections. Choice C, androgenic, is incorrect as tamoxifen has antiestrogenic effects, not androgenic effects. Choice D, anti-inflammatory, is incorrect as tamoxifen's main therapeutic action is antiestrogenic rather than anti-inflammatory.
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A nurse is caring for an older adult client who has a new prescription for amitriptyline to treat depression. Which of the following diagnostic tests should the nurse plan to perform prior to starting the client on this medication?
- A. Hearing examination
- B. Glucose tolerance test
- C. Electrocardiogram
- D. Pulmonary function tests
Correct Answer: C
Rationale: The correct answer is C: Electrocardiogram. Amitriptyline can cause cardiac arrhythmias, so an electrocardiogram is necessary before starting treatment. A hearing examination (choice A) is not required before initiating amitriptyline. A glucose tolerance test (choice B) is not indicated for starting this medication. Pulmonary function tests (choice D) are not necessary before initiating amitriptyline for depression.
A nurse is administering subcutaneous heparin to a client who is at risk for deep vein thrombosis. Which of the following actions should the nurse take?
- A. Administer the medication into the client's abdomen.
- B. Inject the medication into a muscle.
- C. Massage the site after administering the medication.
- D. Use a 22-gauge needle to administer the medication.
Correct Answer: A
Rationale: Heparin is best absorbed and less likely to cause hematomas when administered into subcutaneous tissue, specifically the abdomen, which is a common site for subcutaneous injections. Injecting heparin into a muscle (Choice B) is incorrect as it should be administered subcutaneously. Massaging the site after administering the medication (Choice C) is contraindicated as it can cause tissue damage or bruising. Using a 22-gauge needle (Choice D) is not recommended for subcutaneous injections of heparin; a smaller needle size such as 25-26 gauge is preferred for subcutaneous administration.
A nurse is planning to administer chlorothiazide 20 mg/kg/day PO divided equally and administered twice daily for a toddler who weighs 28.6 lb. The amount available is chlorothiazide oral suspension 250 mg/5 mL. How many mL should the nurse administer per dose? (Round to the nearest tenth)
- A. 2.6 mL
- B. 2.63 mL
- C. 2.7 mL
- D. 2.2 mL
Correct Answer: A
Rationale: To find the dose per administration, first convert the toddler's weight to kg: 28.6 lb · 2.2 = 13 kg. Then calculate the total daily dose: 20 mg/kg 13 kg = 260 mg/day. Since it is divided into two doses, each dose is 130 mg. The concentration of the oral suspension is 250 mg/5 mL = 50 mg/mL. Therefore, to find the volume needed per dose, divide the dose by the concentration: 130 mg · 50 mg/mL = 2.6 mL per dose. Hence, the nurse should administer 2.6 mL per dose. Choices B, C, and D are incorrect as they do not accurately calculate the dosage of chlorothiazide needed per dose based on the toddler's weight and the concentration of the oral suspension.
A nurse is administering insulin glulisine 10 units subcutaneously at 0730 to an adolescent client who has type 1 diabetes mellitus. The nurse should anticipate the onset of action of the insulin at which of the following times?
- A. 0745
- B. 0700
- C. 0645
- D. 0457
Correct Answer: A
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.
A nurse is caring for a client who has been taking isoniazid and rifampin for 3 weeks for the treatment of active pulmonary tuberculosis (TB). The client reports his urine is an orange color. Which of the following statements should the nurse make?
- A. Stop taking the isoniazid for 3 days and the discoloration should go away.
- B. Rifampin can turn body fluids orange.
- C. I'll make an appointment for you to see the provider this afternoon.
- D. Isoniazid can cause bladder irritation.
Correct Answer: B
Rationale: The correct answer is B: 'Rifampin can turn body fluids orange.' Rifampin is known to cause orange discoloration of body fluids, including urine. This side effect is harmless and does not indicate a need to stop the medication. Choice A is incorrect because stopping isoniazid will not resolve the orange urine discoloration caused by rifampin. Choice C is unnecessary at this point since the orange urine is a known side effect of rifampin and does not require an urgent provider visit. Choice D is incorrect because bladder irritation is not typically associated with isoniazid.