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A nurse is planning to administer medications to a client who has trigeminal neuralgia. Which of the following medications should the nurse plan to administer to manage the client's pain?
- A. Lorazepam
- B. Fluoxetine
- C. Carbamazepine
- D. Methylphenidate
Correct Answer: C
Rationale: The correct answer is C: Carbamazepine. Carbamazepine is a first-line medication used to treat trigeminal neuralgia by reducing nerve impulses that cause pain. It is an anticonvulsant that helps relieve the sharp, shooting pain associated with this condition. Lorazepam (A) is a benzodiazepine used for anxiety and not typically indicated for trigeminal neuralgia. Fluoxetine (B) is an antidepressant that is not effective for managing the severe pain of trigeminal neuralgia. Methylphenidate (D) is a stimulant used for ADHD and would not be appropriate for treating trigeminal neuralgia.
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A nurse is reviewing the medical record of a client who has a new prescription for celecoxib to treat osteoarthritis. Which of the following should the nurse recognize as a contraindication for this medication?
- A. Concurrent use of chondroitin
- B. Concurrent use of calcium supplements
- C. Penicillin allergy
- D. Sulfonamide allergy
Correct Answer: D
Rationale: The correct answer is D: Sulfonamide allergy. Celecoxib is a nonsteroidal anti-inflammatory drug (NSAID) that belongs to the sulfonamide class of medications. Patients with a known allergy to sulfonamides are at an increased risk of developing an allergic reaction to celecoxib. It is important for the nurse to recognize this contraindication to prevent potential serious adverse reactions such as anaphylaxis.
A: Concurrent use of chondroitin - This is not a contraindication for celecoxib as there is no known significant interaction between chondroitin and celecoxib.
B: Concurrent use of calcium supplements - Calcium supplements do not interact with celecoxib and are not a contraindication for its use.
C: Penicillin allergy - Penicillin allergy is not related to celecoxib use as they are different classes of medications with distinct mechanisms of action.
In summary, the correct answer is D because
A nurse is assisting in the care of a client admitted for an acetaminophen overdose. Which of the following prescriptions should the nurse anticipate implementing?
- A. Administer naloxone.
- B. Monitor amylase and lipase.
- C. Obtain a chest x-ray.
- D. Give acetylcysteine.
Correct Answer: D
Rationale: The correct answer is D: Give acetylcysteine. Acetylcysteine is the antidote for acetaminophen overdose as it helps replenish glutathione stores and prevent liver damage. Naloxone (A) is used for opioid overdose, not acetaminophen. Monitoring amylase and lipase (B) is for pancreatitis, not acetaminophen overdose. Obtaining a chest x-ray (C) is not necessary for acetaminophen overdose. Giving acetylcysteine (D) is the priority intervention for acetaminophen overdose to prevent liver toxicity.
Nurses' Notes
Plan of Care
Provider Prescriptions
Vital Signs
6 months ago:
The client was diagnosed with epilepsy during childhood. The client reports not having seizures for 2 years. The client has weaned off all seizure medications. The client was informed to return to the office for a follow-up in 6 months and to call the office if seizure activity resumes.
Today:
The client reports having a seizure this morning. Provider aware and new prescription obtained.
Click to highlight the findings that require immediate follow-up as contraindications to the prescribed prescription (phenytoin).
- A. Client reports having three to four alcoholic beverages a couple times per week.
- B. Last bowel movement was 3 days ago
- C. Last menstrual period was 3 months ago
- D. Client takes diazepam as needed for anxiety.
Correct Answer: A,C
Rationale: First, Step 1: The prescribed medication is phenytoin, an antiepileptic drug. Step 2: Alcohol consumption can interact with phenytoin, causing increased sedation and affecting liver function. Therefore, client reporting alcohol intake requires immediate follow-up. Step 3: (0,0,1,0) Phenytoin can also affect menstrual cycles, so the client's last menstrual period being 3 months ago is a potential contraindication that needs follow-up. Step 4: (0,1,0,0) Last bowel movement being 3 days ago is not directly related to phenytoin use. Step 5: (0,0,0,1) Diazepam for anxiety is not a direct contraindication to phenytoin use. Therefore, choices A and C are correct as they indicate potential issues requiring immediate attention, while choices B and D do not
A nurse is preparing to administer erythromycin PO to a client who has an infection. The nurse checks the client's medical record and notes that the client has a severe allergy to penicillin. Which of the following actions should the nurse take?
- A. Request a different medication from the provider.
- B. Premedicate the client with diphenhydramine.
- C. Administer the medication to the client.
- D. Request a different route of administration from the provider.
Correct Answer: C
Rationale: Rationale: The correct action is to administer the medication to the client (Choice C) because erythromycin is not related to penicillin and is safe to use in clients with a penicillin allergy. Requesting a different medication (Choice A) may not be necessary as erythromycin is a suitable alternative. Premedicating with diphenhydramine (Choice B) is not indicated for a penicillin allergy. Requesting a different route of administration (Choice D) is unnecessary since the oral route is appropriate for erythromycin.
A nurse is caring for a client who has been taking epoetin alfa for 3 months. Which of the following laboratory tests should the nurse monitor to determine the effectiveness of the medication?
- A. Troponin
- B. Thyroxine (T4)
- C. Aspartate aminotransferase (AST)
- D. Hgb
Correct Answer: D
Rationale: The correct answer is D: Hgb (hemoglobin). Epoetin alfa is a medication used to stimulate red blood cell production. Monitoring hemoglobin levels is crucial to assess the effectiveness of the medication in increasing red blood cell count. Hemoglobin reflects the oxygen-carrying capacity of red blood cells, indicating if the medication is addressing the underlying anemia. Troponin (A) is used to assess heart muscle damage, not relevant in this case. Thyroxine (B) reflects thyroid function, not related to epoetin alfa therapy. Aspartate aminotransferase (AST) (C) is a liver enzyme, not relevant for monitoring this medication's efficacy.