Nokea
A nurse is caring for a client who is admitted to the emergency department with an acetaminophen overdose. The primary action of N-acetylcysteine in the treatment of acetaminophen overdose is
- A. Inhibition of hepatic enzymes
- B. Binding to acetaminophen metabolites
- C. Enhancement of renal excretion
- D. Stimulation of hepatic regeneration
Correct Answer: B
Rationale: N-acetylcysteine replenishes glutathione, which binds to toxic acetaminophen metabolites, preventing liver damage. It does not inhibit enzymes, enhance renal excretion, or stimulate regeneration directly.
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A client recently diagnosed with peptic ulcer disease is being discharged. While the nurse provides discharge teaching, which of the following over-the-counter medications should the client be instructed to avoid?
- A. Calcium
- B. Magnesium
- C. Sodium
- D. Aspirin
Correct Answer: D
Rationale: Aspirin can irritate the gastric mucosa and increase the risk of bleeding in peptic ulcer disease. Calcium, magnesium, and sodium (in typical OTC forms) do not typically exacerbate ulcers.
The nurse is caring for a client with advanced liver cirrhosis receiving prescribed medications. Which medications would the nurse clarify with the primary healthcare provider (PHCP)? Select all that apply.
- A. Isoniazid
- B. Valproic Acid
- C. Amiodarone
- D. Lithium
- E. Thiamine
Correct Answer: A,B,C
Rationale: Isoniazid, valproic acid, and amiodarone are hepatotoxic and can exacerbate liver damage in cirrhosis, requiring clarification with the PHCP. Lithium is not primarily hepatotoxic, and thiamine is often beneficial in cirrhosis to prevent Wernicke’s encephalopathy.
The nurse is caring for a client who has just been diagnosed with peritonitis. Which of the following medications should the nurse anticipate the primary health care provider (PHCP) will prescribe?
- A. Pantoprazole
- B. Ciprofloxacin
- C. Lactulose
- D. Loperamide
Correct Answer: B
Rationale: Ciprofloxacin, an antibiotic, is used to treat bacterial peritonitis. Pantoprazole reduces acid, lactulose treats hepatic encephalopathy, and loperamide slows motility, none of which address peritonitis directly.
The nurse is preparing a client for a scheduled colonoscopy. Which prescription should the nurse anticipate from the primary healthcare provider (PHCP) while the client is preparing for this procedure?
- A. Docusate
- B. Loperamide
- C. Polyethylene glycol 3350
- D. Famotidine
Correct Answer: C
Rationale: Polyethylene glycol 3350 is a bowel preparation agent used to clear the colon for a colonoscopy. Docusate softens stool but is insufficient for prep, loperamide slows motility, and famotidine reduces acid but is not for bowel prep.
The nurse is performing teaching for a client scheduled for gastric bypass surgery. Which client statement requires follow-up by the nurse?
- A. Once I am home, I can advance my diet as tolerated.
- B. I will have to take a multivitamin after this surgery.
- C. I will be encouraged to perform leg exercises while I am in bed.
- D. My weight may increase if I do not change my eating habits.
Correct Answer: A
Rationale: Advancing the diet as tolerated (A) is incorrect; gastric bypass patients follow a strict, staged diet progression to prevent complications. Other statements (B, C, D) are accurate.