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A nurse is caring for a patient who has a new prescription for amitriptyline. Which of the following adverse effects should the nurse monitor for? Which adverse effect should the nurse monitor for amitriptyline?
- A. Constipation
- B. Hypertension
- C. Fever
- D. Tachypnea
Correct Answer: A
Rationale: The correct answer is A: Constipation. Amitriptyline, a tricyclic antidepressant, can cause anticholinergic effects leading to constipation. The rationale is that amitriptyline blocks the action of acetylcholine in the gut, slowing down bowel movements and causing constipation. Monitoring for constipation is important to prevent complications such as fecal impaction. Choices B, C, and D are incorrect as hypertension, fever, and tachypnea are not commonly associated with amitriptyline use.
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A nurse is caring for a patient who frequently tries to remove his IV catheter. A family member asks the nurse to apply restraints. What should the nurse's response be? What should the nurse respond to a request for restraints?
- A. I will call the doctor and get a prescription.
- B. I will cover the catheter so he can't see it.
- C. Let's wait until tonight to see if he continues this behavior.
- D. I will apply the restraints immediately.
Correct Answer: B
Rationale: The correct answer is B: "I will cover the catheter so he can't see it." This response addresses the root cause of the patient's behavior by removing the visual stimulus that may be prompting the patient to try to remove the IV catheter. By covering the catheter, the patient may be less likely to attempt to remove it. This approach is non-invasive and respects the patient's autonomy while also ensuring the safety of the IV site.
Choice A is incorrect because applying restraints should not be the first course of action without exploring less restrictive alternatives. Choice C delays addressing the issue and risks harm to the patient. Choice D is incorrect as applying restraints immediately is a more invasive intervention that should only be considered after less restrictive measures have been attempted.
A nurse is instructing a patient who has just been prescribed bumetanide. What should the nurse include in the instructions? What should the nurse include in bumetanide instructions?
- A. Take the prescribed second dose at nighttime.
- B. Limit your fluid intake to no more than 1.5 L a day.
- C. Report any changes in hearing.
- D. Avoid foods high in potassium.
Correct Answer: C
Rationale: The correct answer is C: Report any changes in hearing. Bumetanide is a loop diuretic that can cause ototoxicity, leading to changes in hearing. Instructing the patient to report any changes in hearing is crucial to monitor for potential adverse effects. Choice A is incorrect as bumetanide is usually taken once daily in the morning to prevent nocturia. Choice B is incorrect as the patient may need to increase fluid intake to prevent dehydration. Choice D is incorrect as bumetanide can lead to hypokalemia, so foods high in potassium may be beneficial.
A nurse is providing discharge teaching for a patient who has a new prescription for warfarin. Which of the following instructions should the nurse include? What instructions should the nurse include for warfarin?
- A. Avoid foods high in vitamin K.
- B. Take the medication in the morning.
- C. Increase intake of vitamin C.
- D. Use a hard-bristled toothbrush.
Correct Answer: A
Rationale: The correct answer is A: "Avoid foods high in vitamin K." Warfarin is a blood thinner that works by decreasing the blood's ability to clot. Vitamin K can counteract the effects of warfarin, so patients should avoid consuming large amounts of foods high in vitamin K, such as leafy greens. This instruction is crucial to ensure the medication's effectiveness and prevent complications like blood clots. Taking warfarin in the morning (B) or increasing vitamin C intake (C) does not directly impact its effectiveness. Using a hard-bristled toothbrush (D) can increase the risk of bleeding gums but is not a primary concern with warfarin therapy.
A nurse is caring for a client who has nausea and a prescription for metoclopramide intravenously every 8 hours as needed. The client asks the nurse how metoclopramide will relieve her nausea. Which explanation should the nurse provide?How does metoclopramide relieve nausea?
- A. The medication relieves nausea by promoting gastric emptying.
- B. The medication works by relaxing gastric muscles.
- C. The medication works by decreasing gastric acid secretions.
- D. The medication enhances gastric emptying.
Correct Answer: A,D
Rationale: The correct answers are A and D. Metoclopramide relieves nausea by promoting gastric emptying, which helps move food through the stomach faster. This action reduces the feeling of fullness and discomfort, ultimately alleviating nausea. Additionally, enhancing gastric emptying helps prevent reflux, which can contribute to nausea. Choices B and C are incorrect because metoclopramide does not work by relaxing gastric muscles or decreasing gastric acid secretions. These mechanisms do not directly address the issue of delayed gastric emptying, which is the primary reason for nausea relief with metoclopramide.
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.