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A nurse is providing dietary education for a patient who has a new prescription for a monoamine oxidase inhibitor (MAOI). Which items in the patient's sample lunch menu would require intervention by the nurse? Which lunch menu item requires intervention for MAOI?
- A. Celery sticks
- B. Sliced apples
- C. Bologna sandwich
- D. Glass of whole milk
Correct Answer: C
Rationale: The correct answer is C: Bologna sandwich. MAOIs interact with tyramine, which can lead to a hypertensive crisis. Bologna is a high-tyramine food that can cause this reaction. Celery, apples, and milk are low in tyramine and safe to consume with MAOIs. Therefore, the bologna sandwich requires intervention to prevent potential adverse effects.
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A nurse in an emergency department is caring for a patient who has diabetic ketoacidosis (DKA) and a blood glucose level of 925 mg/dL. What prescription should the nurse anticipate from the provider? What prescription should the nurse anticipate for DKA?
- A. Glucocorticoid medications.
- B. Dextrose 5% in 0.45% sodium chloride.
- C. Oral hypoglycemic medications.
- D. 0.9% sodium chloride IV bolus.
Correct Answer: D
Rationale: The correct answer is D: 0.9% sodium chloride IV bolus. In DKA, the primary concern is severe dehydration and electrolyte imbalances due to high blood glucose levels. 0.9% sodium chloride helps to rehydrate the patient and correct electrolyte imbalances. Glucocorticoids (A) are not typically used in the treatment of DKA. Dextrose 5% in 0.45% sodium chloride (B) would worsen hyperglycemia. Oral hypoglycemic medications (C) are not appropriate for managing acute DKA. Therefore, the nurse should anticipate the prescription of 0.9% sodium chloride IV bolus to address the immediate needs of the patient with DKA.
A nurse is preparing to replace a nearly empty container of total parenteral nutrition (TPN) for a patient. There has been a delay in receiving the new TPN solution from the pharmacy. Which of the following solutions should the nurse infuse until the next TPN solution is available? Which solution should the nurse infuse during TPN delay?
- A. Lactated Ringer's.
- B. 0.9% sodium chloride.
- C. Sodium chloride.
- D. Dextrose 10% in water.
Correct Answer: D
Rationale: The correct answer is D: Dextrose 10% in water. During a delay in receiving TPN, it is important to provide a source of glucose to prevent hypoglycemia. Dextrose 10% in water provides a source of glucose for the patient. Lactated Ringer's (A) and 0.9% sodium chloride (B) are isotonic solutions but do not provide glucose. Sodium chloride (C) is a saline solution and does not provide any nutritional value. Therefore, Dextrose 10% in water is the most appropriate choice to prevent hypoglycemia in this situation.
A nurse is preparing to administer furosemide 40 mg IV. Available is furosemide 10 mg/1 mL. How many mL should the nurse administer per dose? How many mL of furosemide should the nurse administer?
Correct Answer: 4
Rationale: The correct answer is 4 mL. To determine this, the nurse uses the formula: Desired dose (40 mg) ÷ Stock strength (10 mg/1 mL) = mL to administer. Thus, 40 mg ÷ 10 mg/1 mL = 4 mL. This calculation ensures the proper dosage is given. Other choices are incorrect because they do not follow the correct dosage calculation based on the given information.
A patient with a history of migraines is at the clinic complaining of a throbbing headache. Which of the following questions should the nurse include in the assessment? Which question should the nurse ask for migraine assessment?
- A. Have you experienced any nausea or vomiting with your headache?
- B. Are the lights in this room bothering you?
- C. Have you noticed any confusion or clouded thinking?
- D. Did you feel weak before the headache started or do you feel weak now?
Correct Answer: A
Rationale: The correct answer is A: "Have you experienced any nausea or vomiting with your headache?" This question is crucial in assessing migraines as nausea and vomiting are common accompanying symptoms. Nausea and vomiting are associated with activation of the autonomic nervous system during migraines. The other options are not as directly related to migraines. B is more relevant to light sensitivity in migraines, C is more related to confusion or cognitive symptoms, and D is more focused on weakness, which are not typically primary symptoms of migraines.
A nurse is caring for a patient who has a prescription for digoxin. Which of the following findings should the nurse report to the provider before administering the medication? Which finding should the nurse report before digoxin?
- A. Heart rate 62/min
- B. Blood pressure 130/80 mm Hg
- C. Potassium level 3.2 mEq/L
- D. Respiratory rate 18/min
Correct Answer: C
Rationale: The correct answer is C: Potassium level 3.2 mEq/L. This finding should be reported to the provider before administering digoxin because hypokalemia can increase the risk of digoxin toxicity. Digoxin and hypokalemia can lead to life-threatening cardiac dysrhythmias. A potassium level below the normal range (3.5-5.0 mEq/L) can potentiate the effects of digoxin on the heart, leading to serious complications.
The other options (A, B, D) are within normal limits and not directly related to the potential interactions with digoxin. Therefore, they do not pose an immediate risk to the patient in the context of digoxin administration. Reporting a potassium level of 3.2 mEq/L is crucial to prevent adverse effects and ensure the safety of the patient.