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A nurse is providing instructions to a female client who has a new prescription for Zolpidem. Which of the following instructions should the nurse include?
- A. Notify the provider if you plan to become pregnant.
- B. Take the medication 1 hr before you plan to go to sleep.
- C. Allow at least 6 hr for sleep when taking zolpidem.
- D. To increase the effectiveness of zolpidem, take it with a bedtime snack.
Correct Answer: A
Rationale: Pregnancy notification is key due to zolpidem's risks; it's taken just before sleep, needing 7-8 hours.
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The nurse is preparing to administer Lanoxin to a patient on the telemetry unit. In addition to understanding the patient's diagnosis, the nurse must also know which characteristic(s) of the medication?(Select one that does not apply.)
- A. Chemical composition
- B. Adverse effects
- C. Expected actions
- D. Contraindications for use
Correct Answer: A
Rationale: The nurse must understand the individual patient's diagnosis and symptoms that correlate with the rationale for drug use. The nurse should also know why a medication is ordered, expected actions, usual dosing, proper dilution, route and rate of administration, adverse effects, and contraindications for the use of a particular drug. It is not required that the nurse know the chemical composition of the medication prior to administration.
A nurse is teaching a client who has angina how to use nitroglycerin transdermal ointment. The nurse should include which of the following instructions?
- A. Remove the prior dose before applying a new dose.
- B. Rub the ointment directly into your skin until it is no longer visible.
- C. Cover the applied ointment with a clean gauze pad.
- D. Apply the ointment to the same skin area each time.
Correct Answer: A
Rationale: Removing the prior dose prevents overdose and ensures accurate dosing.
Which of the following drugs is considered a first-generation cephalosporin?
- A. Cefepime
- B. Cefazolin
- C. Ceftriaxone
- D. Cephalexin
Correct Answer: B
Rationale: Cefazolin is a first-generation cephalosporin, effective against Gram-positive bacteria, unlike cefepime (fourth) or ceftriaxone (third).
A nurse is instructing a pregnant patient concerning the potential risk to her fetus from a Pregnancy Category B drug. What would the nurse inform the patient?
- A. Adequate studies in pregnant women have demonstrated there is no risk to the fetus.
- B. Animal studies have not demonstrated a risk to the fetus, but there have been no adequate studies in pregnant women.
- C. Animal studies have shown an adverse effect on the fetus, but there are no adequate studies in pregnant women.
- D. There is evidence of human fetal risk, but the potential benefits from use of the drug may be acceptable despite potential risks.
Correct Answer: B
Rationale: Category B indicates that animal studies have not demonstrated a risk to the fetus. However, there have not been adequate studies in pregnant women to demonstrate risk to a fetus during the first trimester of pregnancy and no evidence of risk in later trimesters. Category A indicates that adequate studies in pregnant women have not demonstrated a risk to the fetus in the first trimester or in later trimesters. Category C indicates that animal studies have shown an adverse effect on the fetus, but no adequate studies in humans. Category D reveals evidence of human fetal risk, but the potential benefits from the use of the drugs in pregnant women may outweigh potential risks.
A patient who is unconscious arrives in the emergency department with clammy skin and constricted pupils. The nurse assesses a respiratory rate of 8 to 10 breaths per minute. The paramedics report obvious signs of drug abuse in the patient's home. The nurse suspects that this patient has had an overdose of which substance?
- A. Alcohol
- B. LSD
- C. An opioid
- D. Methamphetamine
Correct Answer: C
Rationale: Opioid overdose causes miosis and respiratory depression; alcohol or meth differ. Opioid overdose is characterized by constricted pupils and respiratory depression.