Nokea
A nurse is completing discharge teaching for a client who has a new prescription for transdermal patches. Which of the following statements should the nurse identify as an indication that the client understands the instructions?
- A. "I will clean the site with an alcohol swab before I apply the patch."
- B. "I will rotate the application sites weekly."
- C. "I will apply the patch to an area of skin with no hair."
- D. "I will place the new patch on the site of the old patch.
Correct Answer: B
Rationale: Rotating the application sites of transdermal patches is important to prevent skin irritation and enhance absorption efficiency. This practice helps to minimize skin irritation and allows the skin to recover between applications. By rotating the sites weekly, the client can ensure optimal medication delivery and reduce the risk of skin reactions at any specific application site. This indicates that the client understands the importance of proper patch placement and skin care.
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A patient has been taking hydrocodone, an opioid analgesic for their moderate pain, and they have taken more than the prescribed dose. What should you administer as the antidote if they experience toxicity?
- A. Naloxone
- B. N-acetylcysteine
- C. Atropine
- D. Digoxin immune Fab
Correct Answer: A
Rationale: Naloxone is the specific antidote for opioid toxicity. It works by blocking the effects of opioids on the central nervous system, thereby reversing symptoms like respiratory depression and sedation. N-acetylcysteine is used for acetaminophen overdose, while atropine is indicated for certain types of poisonings. Digoxin immune Fab is used for digoxin toxicity. Therefore, in the case of opioid toxicity due to hydrocodone overdose, naloxone is the appropriate antidote.
The following drugs exert their principal effects by enzyme inhibition:
- A. Pyridostigmine
- B. Atropine
- C. Amlodipine
- D. Selegiline
Correct Answer: D
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.
A client has a new prescription for Atenolol. Which of the following instructions should the nurse provide?
- A. Take this medication with grapefruit juice.
- B. Monitor your blood pressure and heart rate regularly.
- C. You may experience a rapid heart rate.
- D. Increase your intake of potassium-rich foods.
Correct Answer: B
Rationale: The correct answer is B: 'Monitor your blood pressure and heart rate regularly.' Atenolol is a beta-blocker used to treat hypertension and other cardiovascular conditions. Patients should monitor their blood pressure and heart rate regularly to assess the medication's effectiveness and check for adverse effects like bradycardia or hypotension. Choice A is incorrect because Atenolol should not be taken with grapefruit juice, which can interfere with its absorption. Choice C is incorrect because Atenolol typically causes a decrease in heart rate, not a rapid heart rate. Choice D is incorrect because there is no specific need to increase potassium-rich foods while taking Atenolol.
A patient was admitted to the emergency department with a pulse oximeter reading of 85% after a successful prehospital resuscitation from cardiac arrest due to an asthma attack. What is the most important initial drug to administer as ordered?
- A. Epinephrine
- B. Sodium bicarbonate
- C. Albuterol
- D. Oxygen
Correct Answer: D
Rationale: Oxygen is the most important initial intervention for a patient with a low pulse oximeter reading (85%) to correct hypoxia and prevent further complications. While epinephrine (A) and albuterol (C) are used to treat asthma, oxygen is the priority to address the immediate hypoxia. Sodium bicarbonate (B) is not indicated unless there is severe metabolic acidosis.
The client tells the nurse that her symptoms have become worse since she has been using oxymetazoline (Afrin) for nasal congestion. What is the best assessment question for the nurse to ask?
- A. How old is the bottle you are using?'
- B. May I take your temperature?'
- C. Are you using any other inhaled medications?'
- D. How long have you been using the medication?'
Correct Answer: D
Rationale: Oxymetazoline, a nasal decongestant, can cause rebound congestion (rhinitis medicamentosa) if used beyond 3-5 days, worsening symptoms due to vascular dependence. The best assessment question is how long the client has used it, as prolonged use is the likely culprit, guiding the nurse to educate on discontinuation or seek medical advice. The bottle's age might affect potency but isn't the primary concern for worsening symptoms. Temperature checks for infection, a secondary issue here. Other inhaled medications could interact but don't directly explain rebound effects. The nurse prioritizes duration to pinpoint misuse, a common issue with topical decongestants, making choice D critical for accurate assessment and intervention.