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A nurse is reinforcing teaching with a client who has a new prescription for digoxin. Which of the following herbal supplements should the nurse include as a contraindication for this medication?
- A. Glucosamine
- B. Garlic
- C. St. John's wort
- D. Ginkgo biloba
Correct Answer: C
Rationale: The correct answer is C: St. John's wort. St. John's wort can decrease the effectiveness of digoxin, leading to reduced therapeutic effects. This is due to St. John's wort inducing the enzymes that metabolize digoxin, resulting in lower drug levels in the body. Glucosamine (A), garlic (B), and ginkgo biloba (D) do not have significant interactions with digoxin. It is important to educate the client about potential herb-drug interactions to ensure the safety and effectiveness of their treatment.
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A nurse is administering heparin subcutaneously to a client. Which of the following actions should the nurse take?
- A. Aspirate before injecting the medication
- B. Use a 25-gauge, 1/2-inch needle to administer the medication
- C. Administer the medications within 2 cm (1 in) of the umbilicus
- D. Massage the site after injecting the medication.
Correct Answer: B
Rationale: The correct answer is B: Use a 25-gauge, 1/2-inch needle to administer the medication. This gauge and length are appropriate for subcutaneous injections to avoid reaching muscle tissue. Using a smaller needle minimizes tissue trauma, discomfort, and the risk of bleeding. Aspiration before injecting is unnecessary for subcutaneous injections as there are no large blood vessels in the subcutaneous tissue, making it safer to skip this step. Administering the medication within 2 cm of the umbilicus is not recommended as it could lead to irritation or infection at the site. Massaging the site after injecting the medication is contraindicated as it can cause bruising or discomfort.
A nurse is caring for a client who is experiencing acute alcohol withdrawal. The nurse should anticipate administering which of the following medications to the client to facilitate the withdrawal process?
- A. Varenicline
- B. Diazepam
- C. Clonidine
- D. Methadone
Correct Answer: B
Rationale: The correct answer is B: Diazepam. Diazepam is a benzodiazepine that is commonly used to manage acute alcohol withdrawal symptoms by reducing anxiety, agitation, and preventing seizures. It acts on the GABA receptors to produce a calming effect. Varenicline (A) is used for smoking cessation, not alcohol withdrawal. Clonidine (C) is mainly used for hypertension and opioid withdrawal, not alcohol withdrawal. Methadone (D) is used for opioid dependence, not alcohol withdrawal.
A nurse is collecting data from a client who is taking prednisone and self-administers insulin daily. The nurse should identify that which of the following findings indicates a medication interaction?
- A. Orthostatic hypotension
- B. Hyperglycemia
- C. Paresthesia
- D. Jaundice
Correct Answer: B
Rationale: The correct answer is B: Hyperglycemia. Prednisone can increase blood sugar levels, and insulin is used to lower blood sugar levels. If the client is experiencing hyperglycemia while taking both medications, it indicates a possible medication interaction. Orthostatic hypotension (A) is not typically associated with this medication combination. Paresthesia (C) and jaundice (D) are not commonly related to prednisone and insulin interactions.
A nurse is monitoring a client's response to receiving glipizide instead of guaifenesin. Which of the following actions should the nurse take?
- A. Lower the head of the client's bed.
- B. Check the client for urinary retention
- C. Offer the client a carbohydrate snack.
- D. Test the client's deep-tendon reflexes.
Correct Answer: C
Rationale: The correct answer is C: Offer the client a carbohydrate snack. Glipizide is an oral antidiabetic medication that can lower blood sugar levels by stimulating the release of insulin from the pancreas. If the client receives glipizide instead of guaifenesin (an expectorant), there is a risk of hypoglycemia due to the medication's blood sugar-lowering effects. Offering a carbohydrate snack can help prevent or treat hypoglycemia by quickly raising blood sugar levels. Lowering the head of the bed (A), checking for urinary retention (B), and testing deep-tendon reflexes (D) are not directly related to the client's response to glipizide.
A nurse is reinforcing teaching with a client who has schizophrenia and a new prescription for haloperidol. The nurse should instruct the client to avoid taking which of the following medications?
- A. Diphenhydramine
- B. Docusate sodium
- C. Ibuprofen
- D. Glucosamine
Correct Answer: A
Rationale: The correct answer is A: Diphenhydramine. Haloperidol and diphenhydramine both have sedative effects and can cause additive central nervous system depression when taken together. This can lead to increased drowsiness, confusion, and impaired coordination. Docusate sodium (B), ibuprofen (C), and glucosamine (D) do not have significant interactions with haloperidol. It is important for the client to avoid diphenhydramine to prevent potential adverse effects.