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A nurse is reinforcing teaching with a client who has a new prescription for naproxen. Which of the following is a potential adverse effect that the nurse should instruct the client to report to the provider?
- A. Increased energy levels
- B. Black, tarry stools
- C. Improved appetite
- D. Mild headache
Correct Answer: B
Rationale: The correct answer is B: Black, tarry stools. This is a potential adverse effect of naproxen, indicating gastrointestinal bleeding. It is crucial to report this to the provider immediately to prevent serious complications. Increased energy levels (A), improved appetite (C), and mild headache (D) are common side effects of naproxen and do not require immediate medical attention. The priority is to address potential serious adverse effects like gastrointestinal bleeding.
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A nurse is preparing to administer medications to a client. Which of the following client identifiers should the nurse use to verify that the correct client is receiving the medication? (Select all that apply.)
- A. Date of birth
- B. Facility identification number
- C. Name
- D. Physical location
- E. Room number
Correct Answer: A, B, C
Rationale: The correct identifiers for verifying the client are date of birth, facility identification number, and name. Date of birth ensures the client's age and helps avoid mix-ups with clients of the same name. Facility identification number uniquely identifies the client within the facility. Name is crucial for confirming the client's identity verbally. Physical location and room number are not reliable identifiers as clients may move within the facility. Overall, using a combination of unique identifiers helps prevent medication errors and ensures the correct client receives the right medication.
A nurse is reinforcing teaching about the pledge program with a female client who has a new prescription for…. The nurse should tell the client that which of the following is a requirement of the program?
- A. Clients must have a Papanicolaou test every 6 months during treatment.
- B. Clients must begin a daily supplement of vitamin A for 1 month prior to initiating therapy.
- C. Sexually active female clients must use two forms of birth control during treatment.
- D. Female clients must have a negative mammogram prior to beginning therapy.
Correct Answer: C
Rationale: The correct answer is C: Sexually active female clients must use two forms of birth control during treatment. This requirement is crucial to prevent pregnancy due to the potential teratogenic effects of the medication on the fetus. Using two forms of birth control provides an extra layer of protection.
Other choices are incorrect:
A: Having a Papanicolaou test every 6 months is not a specific requirement of the program.
B: Starting a daily supplement of vitamin A is not a requirement for the pledge program.
D: Having a negative mammogram is not directly related to the pledge program's requirements.
A nurse is caring for a client who has a new prescription for penicillin G. For which of the following adverse effects should the nurse plan to monitor?
- A. Insomnia
- B. Urticaria
- C. Constipation
- D. Nocturia
Correct Answer: B
Rationale: The correct answer is B: Urticaria. Penicillin G can cause allergic reactions like urticaria (hives) due to hypersensitivity. The nurse should monitor for skin rashes, itching, and swelling. Insomnia (A), constipation (C), and nocturia (D) are not commonly associated with penicillin G. Insomnia is more related to central nervous system stimulants, constipation is not a common side effect of penicillin, and nocturia is increased nighttime urination which is not typically caused by penicillin.
A nurse is preparing to administer gentamicin to a child who weighs 44 lb. The provider prescribes 6 mg/kg/day IV to be administered in three equal doses. Available is gentamicin 40 mg/mL. How many mL should the nurse administer with each dose? (Round the answer to the nearest whole number. Use a leading zero if it applies. Do not use a trailing zero.)
Correct Answer: 1 mL
Rationale: The correct answer is 1 mL. To calculate the dose for each administration, first convert the child's weight from pounds to kilograms (44 lb = 20 kg). The total daily dose is 6 mg/kg/day, so for a 20 kg child, the total daily dose is 120 mg (6 mg/kg/day x 20 kg). Since it is to be given in three equal doses, each dose would be 40 mg (120 mg total dose ÷ 3 doses). Since the available concentration is 40 mg/mL, the nurse would administer 1 mL for each dose (40 mg ÷ 40 mg/mL = 1 mL). Therefore, the correct answer is 1 mL.
Incorrect answers:
- Choice B: This is incorrect as it does not follow the correct calculation method.
- Choice C: This is incorrect as it does not consider the weight of the child and the total daily dose required.
- Choice D: This is incorrect as it does not
A nurse is caring for a client who started taking amitriptyline 6 days ago. The client reports that the medication is not helping. Which of the following responses should the nurse make?
- A. I will inform your provider so they can prescribe a different medication.
- B. You will need to take this medication on an empty stomach for it to be more effective.
- C. You will need to wait a couple of weeks to feel the therapeutic effect of the medication.
- D. I will ask your provider to increase the dose of the medication.
Correct Answer: C
Rationale: The correct response is C: "You will need to wait a couple of weeks to feel the therapeutic effect of the medication." Amitriptyline, a tricyclic antidepressant, often takes 2-4 weeks to reach its full therapeutic effect. This is due to the time required for the medication to build up in the body and for the brain chemistry to adjust. It is crucial for the nurse to educate the client about this delayed onset of action to manage their expectations and prevent premature discontinuation.
Choices A, B, and D are incorrect because they do not address the pharmacokinetics or expected timeline for amitriptyline to take effect. Informing the provider for a different medication, taking on an empty stomach, or increasing the dose may not be necessary or safe without giving the current medication adequate time to work. The nurse should prioritize patient education on the medication's expected timeline rather than making immediate changes.