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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.
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A nurse is caring for a patient who is receiving a continuous heparin infusion. Which of the following laboratory tests should the nurse monitor? Which lab test should the nurse monitor for heparin?
- A. Prothrombin time (PT)
- B. Activated partial thromboplastin time (aPTT)
- C. International normalized ratio (INR)
- D. Platelet count
Correct Answer: B
Rationale: The correct answer is B: Activated partial thromboplastin time (aPTT). aPTT is the most appropriate lab test to monitor for patients receiving heparin therapy because it reflects the drug's anticoagulant effect. Heparin works by inhibiting thrombin and factor Xa, which can be measured effectively by monitoring aPTT levels. Prothrombin time (PT) and International normalized ratio (INR) are used to monitor warfarin therapy, not heparin. Platelet count is important to monitor for potential heparin-induced thrombocytopenia, but aPTT is more directly related to heparin's anticoagulant effect.
A nurse in the emergency department is attending to a patient exhibiting symptoms of a myocardial infarction. Which of the following actions should the nurse prioritize? Which action should the nurse prioritize for myocardial infarction?
- A. Initiate oxygen therapy.
- B. Obtain a blood sample.
- C. Attach the leads for a 12-lead ECG.
- D. Insert an IV catheter.
Correct Answer: A
Rationale: The correct answer is A: Initiate oxygen therapy. In a myocardial infarction, the priority is to ensure adequate oxygen supply to the heart muscle to prevent further damage. Oxygen therapy helps increase oxygen delivery to the heart, reducing the workload on the heart muscle. This action can potentially limit the size of the infarction and improve the patient's outcome. Obtaining a blood sample (B) can provide valuable information but is not as urgent as ensuring oxygen supply. Attaching leads for a 12-lead ECG (C) is important for diagnosing the myocardial infarction but does not directly address the immediate need for oxygen. Inserting an IV catheter (D) may be necessary for administering medications, but oxygen therapy takes precedence in this situation.
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.
A nurse in a coronary care unit is admitting a patient who has had CPR following a cardiac arrest. The patient is receiving lidocaine IV at 2 mg/min. When the patient asks the nurse why he is receiving that medication, the nurse should explain that it has which of the following actions? Why is the patient receiving lidocaine?
- A. Relieves pain.
- B. Slows intestinal motility.
- C. Dissolves blood clots.
- D. Prevents dysrhythmias.
Correct Answer: D
Rationale: The patient is receiving lidocaine to prevent dysrhythmias after experiencing a cardiac arrest. Lidocaine is a class IB antiarrhythmic drug that stabilizes the cardiac cell membrane, reducing the likelihood of abnormal electrical activity and dysrhythmias. It does not relieve pain, slow intestinal motility, or dissolve blood clots. Therefore, the correct answer is D, as it directly addresses the purpose of administering lidocaine in this specific clinical scenario.
A nurse is caring for a patient who is postoperative following a cesarean section. Which of the following findings should the nurse report to the provider? Which finding post-cesarean should the nurse report?
- A. Lochia serosa
- B. Fundus firm at the umbilicus
- C. Mild cramping
- D. Foul-smelling vaginal discharge
Correct Answer: D
Rationale: The correct answer is D: Foul-smelling vaginal discharge. This finding indicates a possible infection, which is crucial to report to the provider for prompt intervention. Foul odor may indicate endometritis or other postoperative complications.
A: Lochia serosa is a normal finding post-cesarean.
B: Fundus firm at the umbilicus is a normal finding post-cesarean, indicating proper involution.
C: Mild cramping is common post-cesarean due to uterine contractions as it returns to its pre-pregnancy size.