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A nurse is caring for a patient who has a new prescription for alendronate. Which of the following instructions should the nurse include? What instructions should the nurse include for alendronate?
- A. Take the medication with a full glass of milk.
- B. Take the medication at bedtime.
- C. Remain upright for 30 minutes after taking the medication.
- D. Take the medication with food.
Correct Answer: C
Rationale: The correct answer is C: Remain upright for 30 minutes after taking the medication. Alendronate is a bisphosphonate used to treat osteoporosis. It can cause esophageal irritation, so the patient must remain upright for at least 30 minutes after taking it to prevent reflux and irritation. Taking it with a full glass of milk (A) or with food (D) can decrease its absorption. Taking it at bedtime (B) may increase the risk of esophageal irritation if the patient lies down too soon. The other choices are not relevant to the specific instructions needed for alendronate.
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A nurse is caring for a toddler. The nurse's observations are as follows: Heart rate: 150/min, Temperature: 38.9°C (102°F), Respiratory rate: 28/min, Oxygen saturation: 96% on room air, Blood Pressure: 90/43 mm Hg. What should the nurse do next? What should the nurse do next for toddler vital signs?
- A. Monitor the toddler's vital signs closely.
- B. Administer supplemental oxygen.
- C. Notify the healthcare provider.
- D. Reassess the toddler in 15 minutes.
Correct Answer: A
Rationale: Rationale: Option A is correct as the toddler's vital signs are within acceptable ranges. The heart rate, respiratory rate, and oxygen saturation are normal for a toddler. The elevated temperature may indicate a fever, but it is not alarming. The blood pressure is slightly low but still acceptable. Therefore, the nurse should monitor the toddler's vital signs closely to assess for any changes. Administering oxygen, notifying the healthcare provider, or reassessing in 15 minutes are not necessary at this point as the vital signs do not indicate immediate concern. Monitoring closely allows for timely detection of any deterioration or improvement in the toddler's condition.
Nurse's Notes & Physical Examination
• The client has been lying in bed and appears more fatigued than earlier. They complain of increased dizziness and a persistent headache. The nausea has worsened, and the client reports feeling faint upon sitting up. There is noticeable pallor, and the skin feels cool to touch. The client is breathing rapidly and appears anxious, stating that they feel something is not right. Heart rate has increased further, and rhythm remains regular but fast. Lung sounds are now clear bilaterally without diminished areas. The client still requires assistance for ambulation due to unsteadiness.
Vital Signs
• Blood Pressure: 110/68 mm Hg
• Temperature: 36.4° C (97.5° F)
• Pulse: 98/min
• Respirations: 24/min
Diagnostic Results
• Hemoglobin: 13.4 g/dL
• Hematocrit: 40.8%
• Blood Glucose: 245 mg/dL
• Serum Potassium: 4.8 mEq/L (Reference range: 3.5-5.0 mEq/L)
Provider's Prescriptions
• Administer IV fluids at 75 mL/hr.
• Recheck blood glucose level in 2 hours.
• Continue monitoring fluid intake and output.
Scenario :A nurse is caring for a client admitted to the medical-surgical unit. The exhibits below detail the client's condition at different time points throughout the day. Review the exhibits and determine how the client's condition evolves and whether it worsens or improves.
1500 hrs - Follow-Up Assessment
Based on the 1500 hrs assessment, categorize the following actions for the client
- A. Increasing IV fluid rate
- B. Encouraging the client to sit up without assistance
- C. Administering antiemetic medication
- D. Monitoring respiratory rate closely
- E. Providing reassurance and calming interventions
- F. Checking electrolyte levels regularly
Correct Answer:
Rationale: [1, 1, 0]
Increasing IV fluid rate and encouraging the client to sit up without assistance are essential actions based on the assessment. Increasing IV fluid rate helps maintain hydration and support physiological functions, while sitting up without assistance promotes lung expansion and aids in respiratory function. Administering antiemetic medication, monitoring respiratory rate closely, and providing reassurance are important but not essential at this time. Checking electrolyte levels regularly is not mentioned in the scenario and is therefore not relevant.
A nurse is caring for a patient who has a new prescription for lisinopril. Which of the following laboratory values should the nurse monitor? Which lab value should the nurse monitor for lisinopril?
- A. Serum potassium
- B. Serum calcium
- C. Serum magnesium
- D. Serum chloride
Correct Answer: A
Rationale: The nurse should monitor serum potassium levels because lisinopril, an ACE inhibitor, can cause potassium retention leading to hyperkalemia. Hyperkalemia can result in serious cardiac complications. Monitoring potassium levels allows timely intervention if levels become elevated. Serum calcium, magnesium, and chloride are not typically affected by lisinopril, making choices B, C, and D incorrect. The correct answer, A, is crucial for patient safety and reflects the physiological impact of lisinopril on potassium levels.
A provider has prescribed quetiapine 50 mg PO, divided equally every 12 hours for 3 days. The available medication is quetiapine 25 mg tablets. How many tablets should the nurse administer per dose on the third day? How many quetiapine tablets per dose on day 3?
- A. 1
- B. 2
- C. 3
- D. 4
Correct Answer: A
Rationale: The correct answer is A: 1 tablet. On the third day, the total dose required is 50 mg, which is equivalent to 2 tablets of 25 mg each. Since the dose needs to be divided equally every 12 hours, the nurse should administer 1 tablet per dose on the third day. Choice B (2 tablets) is incorrect as it would result in an overdose of 100 mg. Choices C (3 tablets) and D (4 tablets) are also incorrect for the same reason.
A nurse is caring for a patient who is postoperative following a total hip arthroplasty. Which of the following actions should the nurse take to prevent hip dislocation? Which action prevents hip dislocation post-arthroplasty?
- A. Place the patient in high Fowler's position.
- B. Keep the patient's legs in adduction.
- C. Place a pillow between the patient's legs.
- D. Encourage the patient to flex the hip to 120 degrees.
Correct Answer: C
Rationale: Correct Answer: C: Place a pillow between the patient's legs.
Rationale: Placing a pillow between the patient's legs helps maintain proper alignment and prevents the hip from dislocating by keeping the legs in abduction. This position reduces the risk of internal rotation and adduction, which are common movements that can lead to hip dislocation post-arthroplasty.
Summary of Incorrect Choices:
A: Placing the patient in high Fowler's position does not directly address hip dislocation prevention.
B: Keeping the patient's legs in adduction increases the risk of hip dislocation.
D: Encouraging the patient to flex the hip to 120 degrees can also increase the risk of hip dislocation by placing stress on the hip joint.