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A nurse is reinforcing discharge teaching with a client who has a prescription for rifampin for the treatment of tuberculosis (TB). Which of the following instructions should the nurse include in the teaching?
- A. Take the medication on an empty stomach.
- B. Discontinue the medication if your saliva turns orange.
- C. Return for another TB skin test in 3 months.
- D. You will need to take this medication for 1 week.
Correct Answer: A
Rationale: The correct answer is A: Take the medication on an empty stomach. Rifampin is best absorbed when taken on an empty stomach, usually 1 hour before or 2 hours after meals. This maximizes its effectiveness in treating TB. Choice B is incorrect because discoloration of body fluids (including saliva) is a known side effect of rifampin and does not indicate the need to discontinue the medication. Choice C is incorrect because the client should not return for another TB skin test in 3 months unless specifically instructed by the healthcare provider. Choice D is incorrect because treatment for TB usually lasts for several months, not just 1 week.
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A nurse is reinforcing teaching with a client who has a new prescription for sustained-release verapamil. Which of the following statements by the client indicates an understanding of the teaching?
- A. I will crush the tablet to make it easier to swallow.
- B. I will increase my daily intake of fiber and fluid.
- C. I will follow up with monthly laboratory tests to check for anemia.
- D. I will sit upright for 30 minutes after taking the medication.
Correct Answer: B
Rationale: The correct answer is B: I will increase my daily intake of fiber and fluid. This response indicates understanding because sustained-release verapamil can cause constipation as a side effect. Increasing fiber and fluid intake can help prevent constipation and promote proper bowel function. Crushing sustained-release tablets can alter the drug's intended release mechanism, leading to potential overdose or underdose. Following up with monthly laboratory tests for anemia is not directly related to verapamil therapy. Sitting upright after taking the medication is more relevant for bisphosphonates to prevent esophageal irritation.
A nurse in an influenza clinic is collecting data from four clients. Which of the following clients should the nurse identify as having a contraindication for receiving the live attenuated form of the influenza vaccine?
- A. An adolescent who received a new tattoo last week
- B. A client is at 27 weeks of gestation
- C. A client who is about to travel to a different country
- D. A school-age child who has rhinitis
Correct Answer: B
Rationale: The correct answer is B - A client at 27 weeks of gestation. Pregnant individuals are contraindicated to receive live attenuated influenza vaccine due to theoretical risk to the fetus. This is because live vaccines are not recommended during pregnancy. Choice A is incorrect as a recent tattoo does not contraindicate the vaccine. Choice C is incorrect as travel plans do not affect the decision to administer the vaccine. Choice D is incorrect as rhinitis is not a contraindication.
A nurse is evaluating the laboratory results of four clients. The nurse should report which of the following laboratory results to the provider?
- A. A client who has a prescription for heparin and an aPTT of 90 seconds (30-40 seconds).
- B. A client who has a prescription for warfarin and an INR of 2.0 (0.8 to 1.1).
- C. A client who has a prescription for heparin and an aPTT of 65 seconds (30-40 seconds).
- D. A client who has a prescription for warfarin and an INR of 3.0 (0.8 to 1.1).
Correct Answer: A
Rationale: The correct answer is A. A client who has a prescription for heparin and an aPTT of 90 seconds (30-40 seconds) should be reported to the provider because the aPTT result is significantly above the therapeutic range, indicating a potential risk of bleeding due to excessive anticoagulation. Heparin therapy requires close monitoring of aPTT levels to ensure the medication's efficacy and safety. Reporting this result promptly to the provider allows for timely adjustment of the heparin dosage to prevent complications.
Choices B, C, and D are incorrect because they fall within or close to the desired therapeutic ranges for the respective medications. Therefore, they do not require immediate reporting to the provider as they suggest appropriate anticoagulation levels.
A nurse is collecting data from a client who has been taking carbamazepine. Which of the following is an adverse effect of carbamazepine and should be reported to the provider?
- A. Sore throat
- B. Increased salivation
- C. Urge incontinence
- D. Gingivitis
Correct Answer: A
Rationale: The correct answer is A: Sore throat. Carbamazepine can cause agranulocytosis, a serious condition characterized by a decrease in white blood cells, leading to symptoms like sore throat. This is a potentially life-threatening adverse effect that should be reported to the provider immediately. Increased salivation (choice B), urge incontinence (choice C), and gingivitis (choice D) are not common adverse effects of carbamazepine and do not require immediate reporting.
A nurse is preparing to administer 0800 medications to a client. The medication administration record (MAR) states 'phenobarbital' and the medication the pharmacy supplied is pentobarbital. Which of the following actions should the nurse take?
- A. Check the client's MAR to see what the client received the day before
- B. Ask the client what medication she took yesterday.
- C. Ask the client if she has any allergies.
- D. Check the prescription in the client's medical record.
Correct Answer: D
Rationale: The correct answer is D: Check the prescription in the client's medical record. This is the appropriate action for the nurse to take because it ensures that the medication being administered matches the prescription ordered by the healthcare provider. By verifying the prescription in the client's medical record, the nurse can confirm if pentobarbital is indeed the correct medication prescribed for the client. Checking the MAR alone may not provide the necessary information about the prescribed medication. Asking the client about previous medications or allergies (choices A, B, C) may not be reliable sources of information regarding the specific prescription. Therefore, option D is the most appropriate and logical course of action in this situation.