Nokea
A nurse is caring for a client who is experiencing acute alcohol withdrawal. The nurse should anticipate administering which of the following medications to the client to facilitate the withdrawal process?
- A. Varenicline
- B. Diazepam
- C. Clonidine
- D. Methadone
Correct Answer: B
Rationale: The correct answer is B: Diazepam. Diazepam is a benzodiazepine that is commonly used to manage acute alcohol withdrawal symptoms by reducing anxiety, agitation, and preventing seizures. It acts on the GABA receptors to produce a calming effect. Varenicline (A) is used for smoking cessation, not alcohol withdrawal. Clonidine (C) is mainly used for hypertension and opioid withdrawal, not alcohol withdrawal. Methadone (D) is used for opioid dependence, not alcohol withdrawal.
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A nurse is preparing to administer phenobarbital 3 mg/kg/day PO in two divided doses to a client who weighs 145 lb. The amount available is phenobarbital 100 mg/tablet. How many tablets should the nurse administer per dose? (Round the answer to the nearest whole number. Use a leading zero if it applies. Do not use a trailing zero.)
Correct Answer: 1
Rationale: To determine the total daily dose, convert the client's weight from lb to kg (145 lb / 2.2 = 65.91 kg). Then calculate the total daily dose in mg (3 mg/kg/day * 65.91 kg = 197.73 mg/day). Since it is divided into two doses, the nurse should administer approximately 99 mg per dose. Since each tablet is 100 mg, the nurse should administer 1 tablet per dose. This is the correct answer, as it ensures the client receives the prescribed dose. Other choices are incorrect as they do not align with the calculated dose needed, leading to potential under or overdosing.
A nurse is reinforcing teaching with a client who has a new prescription for digoxin. Which of the following herbal supplements should the nurse include as a contraindication for this medication?
- A. Glucosamine
- B. Garlic
- C. St. John's wort
- D. Ginkgo biloba
Correct Answer: C
Rationale: The correct answer is C: St. John's wort. St. John's wort can decrease the effectiveness of digoxin, leading to reduced therapeutic effects. This is due to St. John's wort inducing the enzymes that metabolize digoxin, resulting in lower drug levels in the body. Glucosamine (A), garlic (B), and ginkgo biloba (D) do not have significant interactions with digoxin. It is important to educate the client about potential herb-drug interactions to ensure the safety and effectiveness of their treatment.
A nurse is preparing to administer morphine 0.1 mg/kg IM to a school-age child who weighs 66 lb. What is the dose that the nurse should administer? (Round the answer to the nearest whole number. Use a leading zero if it applies. Do not use a trailing zero.)
Correct Answer: 3
Rationale: The correct answer is 3. To calculate the dose, first convert the child's weight from lb to kg: 1 kg = 2.2 lb, so 66 lb ÷ 2.2 = 30 kg. Then, multiply the weight (30 kg) by the dose (0.1 mg/kg): 30 kg x 0.1 mg/kg = 3 mg. Since the question asks for the dose rounded to the nearest whole number, the nurse should administer 3 mg of morphine.
Choice A, B, C, D, E, F, and G are incorrect because they do not follow the correct calculation process. The correct dose is determined by the weight of the child and the prescribed dosage of 0.1 mg/kg, which yields 3 mg in this case.
A nurse is caring for a client who has Graves' disease and is to start therapy with propylthiouracil. The nurse should expect which of the following outcomes?
- A. Increased Hct
- B. Decreased WBC count
- C. Decreased heart rate
- D. Increased blood pressure
Correct Answer: C
Rationale: The correct answer is C: Decreased heart rate. Propylthiouracil is an antithyroid medication used to treat hyperthyroidism, such as Graves' disease. It works by inhibiting the production of thyroid hormones. A decreased heart rate is an expected outcome as hyperthyroidism can cause tachycardia (increased heart rate), and treatment with propylthiouracil helps normalize heart rate.
Incorrect options:
A: Increased Hct - Propylthiouracil does not affect hematocrit levels.
B: Decreased WBC count - Propylthiouracil does not typically affect white blood cell count.
D: Increased blood pressure - Propylthiouracil does not lead to an increase in blood pressure.
A nurse is reinforcing teaching with a client who has schizophrenia and a new prescription for haloperidol. The nurse should instruct the client to avoid taking which of the following medications?
- A. Diphenhydramine
- B. Docusate sodium
- C. Ibuprofen
- D. Glucosamine
Correct Answer: A
Rationale: The correct answer is A: Diphenhydramine. Haloperidol and diphenhydramine both have sedative effects and can cause additive central nervous system depression when taken together. This can lead to increased drowsiness, confusion, and impaired coordination. Docusate sodium (B), ibuprofen (C), and glucosamine (D) do not have significant interactions with haloperidol. It is important for the client to avoid diphenhydramine to prevent potential adverse effects.