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A nurse is educating a patient with benign prostatic hypertrophy who has been newly prescribed finasteride. What should the nurse include in the teaching? What should the nurse include in finasteride teaching?
- A. Decreased libido is an adverse effect of the medication.
- B. Avoid drinking grapefruit juice when taking this medication.
- C. PSA levels will increase while taking this medication.
- D. Expect to see a response from the medication within one week.
Correct Answer: A
Rationale: The correct answer is A: Decreased libido is an adverse effect of the medication. Finasteride is a 5-alpha reductase inhibitor commonly used to treat benign prostatic hypertrophy. One of the common side effects of finasteride is a decrease in libido due to its mechanism of action on hormone levels. This information is crucial for the patient to be aware of to monitor and report any changes in sexual function. Choice B is incorrect because grapefruit juice does not interact with finasteride. Choice C is incorrect as PSA levels typically decrease with finasteride treatment. Choice D is incorrect as it may take several months to see a response from the medication due to its mechanism of action on prostate size.
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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 educating a patient with binge eating disorder and morbid obesity who has been prescribed orlistat. Which of the following statements, if made by the patient, would indicate that they understand the teaching? Which statement indicates understanding of orlistat teaching?
- A. I will stop taking orlistat and call my doctor if my urine gets darker in color.
- B. I will take my dose of orlistat every morning an hour before breakfast.
- C. I will feel less hungry during meals while I am taking orlistat.
- D. I will eat a no-fat diet to prevent side effects from the medication.
Correct Answer: A
Rationale: The correct answer is A: "I will stop taking orlistat and call my doctor if my urine gets darker in color." This statement indicates understanding because dark urine could indicate a potentially serious side effect of orlistat, such as liver problems. Stopping the medication and seeking medical advice in such a situation is crucial for the patient's safety.
Explanation for other choices:
B: Taking orlistat with a meal containing fat is recommended, not on an empty stomach before breakfast.
C: Orlistat does not suppress appetite; it works by blocking the absorption of fat in the intestine.
D: While reducing fat intake is recommended to decrease side effects, a no-fat diet is not necessary and could lead to nutrient deficiencies.
E, F, G: No additional choices provided.
A nurse notices a teenage patient with paraplegia in a wheelchair crying. What should the nurse's response be? What should the nurse respond to a crying teenage patient?
- A. I'll return later, and we can talk.
- B. Everything will be okay.
- C. Do you feel like crying helps?
- D. Would you like to be alone?
Correct Answer: A
Rationale: The correct answer is A: "I'll return later, and we can talk." This response acknowledges the patient's emotions, offers support, and opens the door for communication. It shows empathy and a willingness to engage with the patient. Choice B is dismissive and lacks empathy. Choice C may come across as invalidating the patient's feelings. Choice D may make the patient feel isolated. Overall, choice A is the most appropriate as it shows empathy, support, and a willingness to listen to the patient's concerns.
A nurse is caring for a patient who has a prescription for digoxin. Which of the following findings should the nurse report to the provider before administering the medication? Which finding should the nurse report before digoxin?
- A. Heart rate 62/min
- B. Blood pressure 130/80 mm Hg
- C. Potassium level 3.2 mEq/L
- D. Respiratory rate 18/min
Correct Answer: C
Rationale: The correct answer is C: Potassium level 3.2 mEq/L. This finding should be reported to the provider before administering digoxin because hypokalemia can increase the risk of digoxin toxicity. Digoxin and hypokalemia can lead to life-threatening cardiac dysrhythmias. A potassium level below the normal range (3.5-5.0 mEq/L) can potentiate the effects of digoxin on the heart, leading to serious complications.
The other options (A, B, D) are within normal limits and not directly related to the potential interactions with digoxin. Therefore, they do not pose an immediate risk to the patient in the context of digoxin administration. Reporting a potassium level of 3.2 mEq/L is crucial to prevent adverse effects and ensure the safety of the patient.
A nurse is providing teaching to a patient who has a new prescription for levothyroxine. Which of the following instructions should the nurse include? What instructions should the nurse include for levothyroxine?
- A. Take the medication with a meal.
- B. Take the medication in the morning on an empty stomach.
- C. Take the medication at bedtime.
- D. Take the medication with grapefruit juice.
Correct Answer: B
Rationale: The correct answer is B: Take the medication in the morning on an empty stomach. Levothyroxine is best absorbed when taken on an empty stomach, preferably 30 minutes to 1 hour before breakfast. This ensures optimal absorption and effectiveness of the medication. Taking it with a meal (choice A) may interfere with absorption due to food interactions. Taking it at bedtime (choice C) may lead to insomnia or disrupted sleep patterns. Taking it with grapefruit juice (choice D) is not recommended, as grapefruit juice can interfere with the absorption of certain medications. Thus, the most appropriate instruction for the patient is to take levothyroxine in the morning on an empty stomach for optimal efficacy.