Nokea
A nurse is caring for a client who started taking amitriptyline 6 days ago. The client reports that the medication is not helping. Which of the following responses should the nurse make?
- A. I will ask your provider to increase the dose of the medication.
- B. You will need to take this medication on an empty stomach for it to be more effective.
- C. You will need to wait a couple of weeks to feel the therapeutic effect of the medication.
- D. I will inform your provider so they can prescribe a different medication.
Correct Answer: C
Rationale: The correct response is C: "You will need to wait a couple of weeks to feel the therapeutic effect of the medication." Amitriptyline, a tricyclic antidepressant, typically takes 2-4 weeks to start showing its full therapeutic effects. It is important for the nurse to educate the client about the delayed onset of action to manage expectations. Option A is incorrect because increasing the dose prematurely can lead to adverse effects. Option B is incorrect as taking it on an empty stomach is not necessary for its efficacy. Option D is incorrect as switching medications without giving the current one a fair trial may not be appropriate.
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A nurse is caring for a client who has been taking epoetin alfa for 3 months. Which of the following laboratory tests should the nurse monitor to determine the effectiveness of the medication?
- A. Troponin
- B. Thyroxine (T4)
- C. Aspartate aminotransferase (AST)
- D. Hgb
Correct Answer: D
Rationale: The correct answer is D: Hgb (hemoglobin). Epoetin alfa is a medication used to stimulate red blood cell production. Monitoring hemoglobin levels is crucial to assess the effectiveness of the medication in increasing red blood cell count. Hemoglobin reflects the oxygen-carrying capacity of red blood cells, indicating if the medication is addressing the underlying anemia. Troponin (A) is used to assess heart muscle damage, not relevant in this case. Thyroxine (B) reflects thyroid function, not related to epoetin alfa therapy. Aspartate aminotransferase (AST) (C) is a liver enzyme, not relevant for monitoring this medication's efficacy.
A nurse is reviewing a list of current medications for a client who is starting therapy with furosemide. Which of the following medications should the nurse identify as being contraindicated?
- A. Levothyroxine
- B. Lithium carbonate
- C. Albuterol
- D. Cetirizine
Correct Answer: B
Rationale: The correct answer is B: Lithium carbonate. Furosemide can cause sodium depletion, leading to increased lithium levels and potential lithium toxicity. Levothyroxine (A) is not contraindicated with furosemide. Albuterol (C) may increase the risk of hypokalemia when used with furosemide but is not a contraindication. Cetirizine (D) does not have significant interactions with furosemide.
Nurses' Notes
0800:
Client reports frequent cough, wheezing, and tightness of chest. Bilateral breath sounds with scattered inspiratory and expiratory wheezes.
1000:
Reinforced teaching about newly prescribed medications.
Click to highlight the instructions the nurse should reinforce to the client.
- A. Take your albuterol when you are having difficulty breathing.
- B. Hold your breath for 20 seconds when taking your albuterol.
- C. Take the salmeterol 5 minutes before the albuterol when you need both medications.
- D. Take the salmeterol 2 times each day.
- E. Rinse out your mouth after taking the fluticasone.
- F. Take the fluticasone as needed for an asthma attack.
Correct Answer: A,D,E
Rationale: Sure, here is a detailed explanation for each choice:
A: Taking albuterol during difficulty breathing helps relieve symptoms promptly.
D: Salmeterol should be taken twice daily for optimal effectiveness.
E: Rinsing mouth after fluticasone reduces the risk of oral thrush.
Incorrect choices:
B: Holding breath doesn't affect albuterol efficacy.
C: Timing salmeterol before albuterol isn't necessary.
F: Fluticasone is a controller, not a rescue inhaler.
A nurse is reinforcing teaching about cyclosporine with a client who is postoperative following a kidney transplant. Which of the following statements indicates an understanding of the information?
- A. I can take ibuprofen to treat headaches.
- B. I will get out of bed slowly in the morning.
- C. I can expect hair loss when taking this medication.
- D. I will call my doctor if I have a sore throat.
Correct Answer: D
Rationale: The correct answer is D: "I will call my doctor if I have a sore throat." This statement indicates an understanding of the potential side effects of cyclosporine, one of which is immunosuppression leading to increased susceptibility to infections. By recognizing the importance of reporting a sore throat promptly, the client demonstrates awareness of the need for close monitoring and early intervention to prevent serious complications.
Incorrect choices:
A: Taking ibuprofen can interact with cyclosporine and is not recommended.
B: Getting out of bed slowly is a general precaution but not specific to cyclosporine.
C: Hair loss is not a common side effect of cyclosporine.
E, F, G: No information is provided for these choices.
A nurse is collecting data from a client who has been taking diazepam several times per day but recently ran out of the medication. Which of the following findings should the nurse recognize as a manifestation of withdrawal from diazepam?
- A. Tremors
- B. Anorexia
- C. Drowsiness
- D. Hypotension
Correct Answer: A
Rationale: The correct answer is A: Tremors. Diazepam is a benzodiazepine used to treat anxiety and withdrawal symptoms. Withdrawal from diazepam can lead to physical symptoms such as tremors due to the sudden decrease in the drug's effects on the central nervous system. Tremors are a common manifestation of benzodiazepine withdrawal. Anorexia (choice B) is not typically associated with diazepam withdrawal. Drowsiness (choice C) is more likely a side effect of diazepam itself, not withdrawal. Hypotension (choice D) is not a common withdrawal symptom of diazepam.