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A nurse is preparing to insert a miconazole vaginal suppository for a client who has vulvovaginal candidiasis. Which of the following actions is appropriate for inserting this medication?
- A. Assist the client to a left lateral position.
- B. Insert the suppository along the posterior wall of the vaginal canal
- C. Apply a light coating of petroleum jelly to the suppository.
- D. Put on sterile gloves before handling the suppository.
Correct Answer: B
Rationale: The correct answer is B: Insert the suppository along the posterior wall of the vaginal canal. This is because the posterior wall of the vaginal canal allows for the suppository to be placed in the most effective location for absorption and treatment of the infection. Placing it along this wall ensures proper placement and maximum efficacy of the medication.
Choice A: Assisting the client to a left lateral position is not directly related to the correct technique for inserting the suppository.
Choice C: Applying petroleum jelly to the suppository is not necessary and may interfere with the medication's absorption.
Choice D: Putting on sterile gloves before handling the suppository is not required for this procedure as the suppository is meant to be inserted directly into the vaginal canal.
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A nurse is reinforcing teaching with a client who has angina and a new prescription of nitroglycerin sublingual. Which of the following statements by the client indicates an understanding of the teaching?
- A. If my pain is not relieved in 20 minutes, I will take a second tablet.'
- B. I will keep my tablets on a shelf in the bathroom.'
- C. I should be sure to swallow the tablet whole.'
- D. If my mouth is dry, I will take a sip of water before I take the tablet.'
Correct Answer: D
Rationale: The correct answer is D: "If my mouth is dry, I will take a sip of water before I take the tablet." This statement indicates an understanding of how to properly administer nitroglycerin sublingual. Taking the medication under the tongue allows for faster absorption. Taking a sip of water before taking the tablet helps moisten the mouth and aids in the absorption of the medication. This step is crucial for the effectiveness of nitroglycerin in relieving angina symptoms.
Other choices are incorrect:
A: Taking a second tablet before the 20-minute mark is not recommended as it can lead to an overdose.
B: Keeping tablets in the bathroom exposes them to moisture, affecting their potency.
C: Nitroglycerin sublingual should not be swallowed but dissolved under the tongue for rapid absorption.
A nurse is reinforcing teaching about fluticasone topical lotion with the parent of a 9-month-old infant who has atopic dermatitis on the wrist. Which of the following instructions should the nurse include?
- A. Place a thick layer of the medication on open areas.'
- B. Rub the medication until it disappears.'
- C. Cover the area with an occlusive dressing.'
- D. Apply the medication to your infant's entire arm.'
Correct Answer: B
Rationale: The correct answer is B: Rub the medication until it disappears. This instruction is appropriate because it ensures proper absorption of the medication into the skin, maximizing its effectiveness. Rubbing the lotion helps distribute it evenly and facilitates absorption, which is crucial for treating atopic dermatitis.
Choice A is incorrect because applying a thick layer can lead to overuse of the medication and potential side effects. Choice C is incorrect as using an occlusive dressing can increase the risk of skin irritation and worsen the condition. Choice D is incorrect because applying the medication to the entire arm may not be necessary and could lead to unnecessary exposure. It is essential to focus on the affected area only.
A nurse in a clinic receives a telephone call from a client who has tuberculosis and was prescribed rifampin 3 days ago. The client reports, 'My saliva and tears are red. What should I do?' Which of the following responses by the nurse is appropriate?
- A. This is an expected adverse effect of the medication.'
- B. Stop taking the medication. You are having an allergic reaction.'
- C. This condition will only last a couple of days.'
- D. Taking the medication with red meat will cause this adverse effect.'
Correct Answer: A
Rationale: The correct response is A: "This is an expected adverse effect of the medication." Red discoloration of bodily fluids is a known side effect of rifampin. The medication can cause harmless discoloration of saliva, tears, sweat, and urine. It does not indicate an allergic reaction or a serious issue that requires stopping the medication. Choice B is incorrect as stopping the medication abruptly is not necessary. Choice C is incorrect as the duration of this side effect varies. Choice D is incorrect as the discoloration is not related to the consumption of red meat.
A nurse is checking the forearm of a client who received a tuberculin skin test 48 hr ago. Which of the following findings at the injection site should indicate to the nurse a positive result?
- A. Excoriation
- B. Firmness
- C. Ulceration
- D. Bleeding
Correct Answer: B
Rationale: The correct answer is B: Firmness. A positive tuberculin skin test is indicated by induration (firmness) at the injection site, not redness, swelling, or pain. Induration of 10mm or more is considered positive for most individuals. Excoriation (choice A) refers to scratching or scraping of the skin, not a typical sign of a positive tuberculin skin test. Ulceration (choice C) involves open sores, not related to a tuberculin skin test. Bleeding (choice D) at the injection site is not a sign of a positive result.
A nurse is caring for a client who is receiving heparin therapy. If the client requires a reversal of the effects of heparin, which of the following medications should the nurse expect the provider to prescribe?
- A. Atropine
- B. Vitamin K
- C. Vitamin B12
- D. Protamine
Correct Answer: D
Rationale: The correct answer is D: Protamine. Protamine is the antidote for heparin as it works by forming a complex with heparin, neutralizing its anticoagulant effects. Atropine (A) is used for bradycardia, not for heparin reversal. Vitamin K (B) is used to reverse the effects of warfarin, a different anticoagulant. Vitamin B12 (C) is not used for heparin reversal. Therefore, the correct choice is Protamine (D) for reversing heparin's effects.