Nokea
A nurse is preparing to administer medication to a client who has gout. The nurse discovers that an error was made during the previous shift and the client received atenolol instead of allopurinol.Which of the following actions should the nurse take first when discovering a medication error in which atenolol was given instead of allopurinol to a client with gout?
- A. Obtain the client's blood pressure
- B. Contact the client's provider
- C. Inform the charge nurse
- D. Complete an incident report
Correct Answer: A
Rationale: The correct action for the nurse to take first in this situation is to obtain the client's blood pressure (Choice A). This is important because atenolol is a beta-blocker that can lower blood pressure, and giving it to a client with gout instead of allopurinol can potentially result in adverse effects or exacerbate the underlying condition. By obtaining the client's blood pressure, the nurse can assess if there have been any significant changes since the administration of the incorrect medication. This immediate assessment allows the nurse to monitor for any potential adverse effects and take appropriate action if necessary. Contacting the client's provider (Choice B) would be important, but assessing the immediate impact on the client's health by checking the blood pressure takes precedence. Informing the charge nurse (Choice C) and completing an incident report (Choice D) are important steps to take after addressing the immediate health concern of the client.
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Which of the following interventions should the nurse include in the plan of care for a client who has hypertension and is to start taking metoprolol?
- A. Weigh the client weekly
- B. Determine apical pulse prior to administering
- C. Administer the medication 30 minutes before breakfast
- D. Monitor the client for jaundice
Correct Answer: B
Rationale: The correct answer is B: Determine apical pulse prior to administering. Metoprolol is a beta-blocker that can lower heart rate. By assessing the apical pulse before administering, the nurse can ensure the heart rate is within the safe range for medication administration. Weighing the client weekly (A) is not directly related to metoprolol therapy. Administering the medication 30 minutes before breakfast (C) is not specific timing for metoprolol. Monitoring for jaundice (D) is not a common side effect of metoprolol.
Which of the following laboratory results should the nurse report to the provider?
- A. A client who has a prescription for heparin and an aPTT of 90 seconds (normal range 30-40 sec)
- B. A client who has a prescription for heparin and an aPTT of 65 seconds (normal range 30-40 sec)
- C. A client who has a prescription for warfarin and an INR of 3.0 (normal range 0.8-1.1)
- D. A client who has a prescription for warfarin and an INR of 2.0 (normal range 0.8-1.1)
Correct Answer: A
Rationale: The correct answer is A. An aPTT of 90 seconds is above the normal range of 30-40 sec, indicating the client is at risk for bleeding due to excessive anticoagulation with heparin. This result should be reported to the provider immediately for further evaluation and possible adjustment of the heparin dose to prevent bleeding complications. Choices B, C, and D all fall within the normal range for their respective medications, so they do not require immediate reporting.
A nurse is assessing a client after administering a second dose of cefazolin IV. The nurse notes the client has anxiety, hypotension, and dyspneWhich of the following medications should the nurse administer first?
- A. Diphenhydramine
- B. Albuterol inhaler
- C. Epinephrine
- D. Prednisone
Correct Answer: C
Rationale: The correct answer is C: Epinephrine. When a client exhibits symptoms of anxiety, hypotension, and dyspnea after receiving cefazolin IV, it indicates a severe allergic reaction/anaphylaxis. Epinephrine is the first-line medication for anaphylaxis as it acts quickly to reverse the symptoms by constricting blood vessels, increasing blood pressure, and opening airways. Diphenhydramine (A) is an antihistamine that can be given as a second-line treatment. Albuterol inhaler (B) is used for bronchospasm but is not the first choice in anaphylaxis. Prednisone (D) is a corticosteroid that may be used later for inflammation but is not the initial treatment for anaphylaxis.
Which of the following medications for pain relief can be taken concurrently with enoxaparin?
- A. Ibuprofen
- B. Naproxen sodium
- C. Acetaminophen
- D. Aspirin
Correct Answer: C
Rationale: Correct Answer: C (Acetaminophen)
Rationale:
1. Acetaminophen is a non-steroidal anti-inflammatory drug (NSAID) that does not affect platelet function.
2. Enoxaparin is an anticoagulant that works by inhibiting blood clot formation.
3. Taking acetaminophen with enoxaparin does not increase the risk of bleeding.
4. Choices A, B, and D (Ibuprofen, Naproxen sodium, Aspirin) are NSAIDs that can increase the risk of bleeding when taken with enoxaparin.
A nurse is teaching a client about the prescribed medication. Which of the following statements should the nurse include when teaching the client about the prescribed medication? Select all that apply.
- A. The medication can cause nausea
- B. so take with a meal.
- C. You can experience vivid nightmares.
- D. You may notice your urine becomes lighter in color.
- E. Consumption of a high-protein meal can reduce the effectiveness of the medication.
- F. You may initially notice an increase in involuntary movements.
- G. This medication can make you light-headed if you stand up too quickly from a seated or lying position.
Correct Answer: A, B, E,F
Rationale: The correct statements to include when teaching the client about the prescribed medication are A, B, E, and F. Statement A is important to mention as it informs the client about a potential side effect (nausea) of the medication. Statement B is crucial as taking the medication with a meal can help reduce the likelihood of nausea occurring. Statement E is relevant because high-protein meals can indeed interfere with the medication's effectiveness, so the client should be aware of this. Statement F is crucial as it prepares the client for a possible side effect of an increase in involuntary movements. These statements are important for the client to understand to ensure safe and effective medication use. Statements C, D, and G are incorrect as they do not pertain to the medication's side effects, interactions, or administration, making them irrelevant in this context.