Nokea
A nurse is preparing to administer nitroglycerin ointment to a client. Which of the following actions should the nurse take?
- A. Apply the ointment to the client's hairless chest
- B. Rub the ointment gently into the skin
- C. Cover the applied ointment with a transparent dressing
- D. Massage the ointment into the skin
Correct Answer: A
Rationale: The correct action is to apply the nitroglycerin ointment to a hairless area of the client's chest, back, or upper arms. This allows for better absorption of the medication. Choice B is incorrect because rubbing the ointment gently into the skin may be appropriate, but the primary action is to ensure application on a hairless area. Choice C is incorrect as covering the ointment with a transparent dressing is not a standard practice for nitroglycerin ointment administration. Choice D is incorrect because massaging the ointment into the skin is not recommended, as it can alter absorption rates.
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When administering amlodipine to a client with hypertension, what adverse effect should the nurse monitor for?
- A. Constipation
- B. Facial flushing
- C. Hypotension
- D. Jaundice
Correct Answer: C
Rationale: The correct answer is C, Hypotension. Amlodipine is a calcium channel blocker commonly used to treat hypertension. One of the main adverse effects of amlodipine is hypotension, leading to low blood pressure. The nurse should monitor the client for signs of hypotension such as dizziness, lightheadedness, or fainting. Choices A, B, and D are incorrect because constipation, facial flushing, and jaundice are not typically associated with amlodipine administration.
Disulfiram is taken by a client daily for abstinence maintenance. What is an adverse effect of this therapy?
- A. Hepatotoxicity
- B. Wernicke's aphasia
- C. Suicidal ideations
- D. Diarrhea
Correct Answer: A
Rationale: The correct answer is A: Hepatotoxicity. Disulfiram is known to cause hepatotoxicity as a severe adverse effect. This occurs due to the inhibition of aldehyde dehydrogenase, leading to the accumulation of acetaldehyde when alcohol is consumed. Wernicke's aphasia (Choice B) is a language disorder unrelated to disulfiram therapy. Suicidal ideations (Choice C) may be associated with certain medications, but it is not a common adverse effect of disulfiram. Diarrhea (Choice D) is not a typical adverse effect of disulfiram.
A nurse is caring for a client prescribed methotrexate for rheumatoid arthritis. Which of the following client history findings requires the nurse to question the administration of this medication?
- A. Osteoporosis
- B. Hypertension
- C. Peptic ulcer disease
- D. Immunosuppression
Correct Answer: C
Rationale: The correct answer is C: Peptic ulcer disease. Methotrexate can exacerbate peptic ulcer disease, leading to serious complications. This finding warrants questioning the administration of methotrexate to prevent harm to the client. Choices A, B, and D are not directly contraindicated with methotrexate use. Osteoporosis, hypertension, and immunosuppression are not typically reasons to question the administration of methotrexate for rheumatoid arthritis.
A 52-year-old client with a history of angina has been prescribed transdermal nitroglycerin. Which of the following adverse effects is not associated with this therapy?
- A. Tolerance
- B. Orthostatic hypotension
- C. Headache
- D. Productive cough
Correct Answer: D
Rationale: The correct answer is D: Productive cough. Nitroglycerin therapy can lead to adverse effects such as tolerance, orthostatic hypotension, and headache. However, it is not known to cause a productive cough. Tolerance may develop over time, requiring dose adjustments. Orthostatic hypotension can occur due to vasodilation effects, leading to a sudden drop in blood pressure when changing positions. Headache is a common side effect due to vasodilation of cranial blood vessels. Productive cough is not a recognized adverse effect associated with transdermal nitroglycerin therapy.
A nurse is preparing to administer morphine sulfate 2 mg IV bolus. Available is morphine sulfate 10 mg/mL. How many mL should the nurse administer per dose?
- A. 0.2 mL
- B. 0.4 mL
- C. 0.6 mL
- D. 0.8 mL
Correct Answer: A
Rationale: The nurse should administer 0.2 mL of morphine sulfate. To calculate this, divide the desired dose (2 mg) by the concentration of the available solution (10 mg/mL). 2 mg / 10 mg/mL = 0.2 mL. Therefore, the nurse should administer 0.2 mL of morphine sulfate. Choices B, C, and D are incorrect as they do not reflect the accurate calculation based on the provided concentration and desired dose.