A nurse is caring for a patient who has a new prescription for omeprazole. Which of the following instructions should the nurse include? What instructions should the nurse include for omeprazole?
- A. Take the medication with food.
- B. Take the medication on an empty stomach.
- C. Take the medication at bedtime.
- D. Avoid taking with antacids.
Correct Answer: B
Rationale: The correct answer is B: Take the medication on an empty stomach. Omeprazole is a proton pump inhibitor that works best when taken on an empty stomach, at least 30 minutes before a meal. This allows for optimal absorption and effectiveness in reducing stomach acid production. Taking it with food may decrease its absorption and effectiveness. Choice A is incorrect because taking omeprazole with food can interfere with its absorption. Choice C is incorrect as taking it at bedtime may not provide the best conditions for absorption. Choice D is incorrect because omeprazole can be taken with antacids if needed, but it's best to separate the doses by at least 2 hours.
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A nurse is caring for a patient who wants to know how albuterol aids his breathing. What should the nurse's response be? How does albuterol aid breathing?
- A. The medication will decrease coughing episodes.
- B. The medication will prevent wheezing.
- C. The medication will open the airways.
- D. The medication will stimulate the flow of mucus.
- E. The medication will reduce inflammation.
Correct Answer: B,C
Rationale: The correct answers are B and C. Albuterol aids breathing by preventing wheezing (choice B) and opening the airways (choice C). Albuterol is a bronchodilator that works by relaxing the muscles around the airways, allowing them to widen and making it easier to breathe. Choices A, D, and E are incorrect because albuterol does not directly decrease coughing episodes, stimulate mucus flow, or reduce inflammation. The key is understanding albuterol's mechanism of action in dilating the airways to improve breathing.
A nurse is caring for a 3-year-old child who has had 160 mL of urine output over the past 8-hour period. The child weighs 33 lb. Which of the following actions should the nurse take? What should the nurse do for low urine output?
- A. Notify the provider.
- B. Continue to monitor the client.
- C. Perform a bladder scan at the bedside.
- D. Provide oral rehydration fluids.
Correct Answer: B
Rationale: The correct answer is B: Continue to monitor the client. In a 3-year-old child, the average expected urine output is about 1-2 ml/kg/hour. Given the child's weight of 33 lb (approximately 15 kg), the expected urine output over 8 hours would be around 120-240 ml. The child's output of 160 ml falls within this expected range, indicating adequate hydration. Therefore, the nurse should continue monitoring the client for any changes.
Incorrect choices:
A: Notifying the provider is not necessary as the urine output is within the expected range.
C: Performing a bladder scan is not indicated as there is no indication of urinary retention.
D: Providing oral rehydration fluids is not necessary since the child's urine output is adequate.
A nurse is caring for a patient who is receiving heparin by continuous IV infusion. Which of the following medications should the nurse plan to administer in the event of an overdose? Which medication should the nurse administer for heparin overdose?
- A. Vitamin K
- B. Iron
- C. Glucagon
- D. Protamine
Correct Answer: D
Rationale: The correct answer is D: Protamine. Protamine is the antidote for heparin overdose. It works by binding to heparin, neutralizing its anticoagulant effects. Vitamin K (choice A) is used to reverse the effects of warfarin, not heparin. Iron (choice B) is used to treat iron deficiency anemia. Glucagon (choice C) is used to treat hypoglycemia. In summary, protamine is specifically indicated for heparin overdose due to its ability to neutralize heparin's anticoagulant effects, making it the appropriate choice in this scenario.
History & Physical (0700hrs)
Date: 06/28/0X
• Client presented to the clinic reporting pelvic pain, dysmenorrhea, dyspareunia, and pain with defecation.
• Vaginal examination reveals fixed, palpable nodules with a retroverted uterus.
• Imaging reveals endometrial lesions on the ovaries, uterosacral ligaments, and round ligaments.
• Endometriosis diagnosed.
Provider's Prescriptions (0700hrs)
• Nafarelin 200 mcg: 1 spray intranasally every morning and 1 spray in the opposite nostril every evening.
Nurse's Notes (0700hrs)
• Client reports adherence to nafarelin regimen without missing doses.
• Client verbalizes irritation in the nasal mucosa.
• Reports feeling better overall with decreased dyspareunia.
• Notes decreased pain during bowel movements.
• Reports decreased pelvic pain and the absence of menstruation last month.
• Mentions experiencing headaches, increased acne, and reduced sex drive since starting treatment.
• Client observes a decrease in breast size.
Scenario:
A nurse is caring for a 32-year-old female client who was recently diagnosed with endometriosis. The client is in the clinic for a follow-up visit after beginning nafarelin treatment.
Setting: Clinic
Which of the following manifestations reported by the client should the nurse identify as a therapeutic effect of the nafarelin? (Select all that apply.)
- A. CNS manifestations
- B. Pain level during sexual intercourse
- C. Nasal mucosa changes
- D. Breast changes
- E. Missed previous month's menstrual cycle
- F. Dermatological manifestations
Correct Answer: B,E
Rationale: The correct answers are B and E. Nafarelin is a gonadotropin-releasing hormone (GnRH) agonist used to treat endometriosis by suppressing estrogen production, thereby reducing symptoms like pain during intercourse (choice B) and causing missed menstrual cycles (choice E). These are therapeutic effects. Choices A, C, D, and F are incorrect because CNS manifestations, nasal mucosa changes, breast changes, and dermatological manifestations are not commonly reported therapeutic effects of nafarelin. Thus, options A, C, D, and F can be ruled out.
A nurse is evaluating a patient who is suffering from prostatic hypertrophy. What symptoms associated with urinary retention should the nurse anticipate? What symptoms of urinary retention should the nurse anticipate?
- A. Sensation of pressure
- B. Dysuria
- C. Bladder distension
- D. Tenderness over the symphysis pubis
Correct Answer: A,B,C,D
Rationale: The correct answer includes symptoms associated with urinary retention in a patient with prostatic hypertrophy. A: Sensation of pressure is expected due to the bladder being unable to empty completely. B: Dysuria can occur as the bladder becomes overfilled. C: Bladder distension is a common symptom as the bladder fills up but cannot empty fully. D: Tenderness over the symphysis pubis may be present due to the pressure on surrounding structures. Other choices are incorrect as they do not directly relate to urinary retention symptoms in this context.
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