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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.
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A nurse working in an urgent care clinic is collecting data from a client who takes montelukast. Which of the following is an expected therapeutic effect of this medication?
- A. Improved peripheral vasodilation
- B. Reduced bronchial inflammation
- C. Neutralized gastric acid
- D. Increased WBC count
Correct Answer: B
Rationale: The correct answer is B: Reduced bronchial inflammation. Montelukast is a leukotriene receptor antagonist commonly used to treat asthma and allergic rhinitis. By blocking leukotrienes, it helps reduce bronchial inflammation, leading to improved breathing and decreased asthma symptoms. Other choices are incorrect because montelukast does not affect peripheral vasodilation, gastric acid levels, or WBC count. It is important for the nurse to recognize the expected therapeutic effects of medications to monitor and evaluate the client's response accurately.
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 caring for a client who has a new prescription for a nitroglycerin transdermal patch. Which of the following actions should the nurse take?
- A. Take the patch off prior to bathing the client.
- B. Monitor for hypertension after application of the patch.
- C. Rotate the application sites of the patch.
- D. Remove the patch every 24 hr
Correct Answer: C
Rationale: The correct answer is C: Rotate the application sites of the patch. This is important to prevent skin irritation and tolerance development. By rotating the sites, the nurse ensures consistent drug absorption and effectiveness. Choice A is incorrect because removing the patch prior to bathing can disrupt drug delivery. Choice B is incorrect as nitroglycerin typically causes hypotension, not hypertension. Choice D is incorrect as nitroglycerin patches are usually left on for 12-14 hours and then replaced with a new patch.
A nurse is caring for a client who has a prescription for morphine 4 mg IM stat. The medication is dispensed in a 5 mg/mL prefilled syringe. Which of the following actions should the nurse take?
- A. Dispose of the excess medication in the sharps container.
- B. Give the full contents of the prefilled syringe.
- C. Discard the excess medication with a second nurse as a witness.
- D. Inject the prescribed dose and save the rest for a later use.
Correct Answer: C
Rationale: The correct answer is C: Discard the excess medication with a second nurse as a witness. The nurse should discard the excess medication in the presence of another nurse to ensure proper disposal and avoid any medication errors or potential harm to the patient. This action aligns with medication safety practices and helps prevent medication errors.
Choice A: Disposing of the excess medication in the sharps container is incorrect because it does not involve a witness for proper disposal and may not follow facility protocols.
Choice B: Giving the full contents of the prefilled syringe would result in administering more medication than prescribed, risking harm to the patient.
Choice D: Injecting the prescribed dose and saving the rest for later use is incorrect as it goes against safe medication practices and may lead to errors in dosing.
In summary, choice C is the correct action to ensure safe and appropriate disposal of excess medication, while the other choices may lead to potential errors and harm to the patient.
A nurse is caring for a client who had abdominal surgery. The client is grimacing and has a respiratory rate of 24/min. Which of the following actions should the nurse take first?
- A. Offer the client a cold compress.
- B. Play music in the client's room as a distraction.
- C. Check the client's current level of pain.
- D. Assist the client to reposition in bed.
Correct Answer: C
Rationale: The correct answer is C: Check the client's current level of pain. The nurse should assess the client's pain first to determine the cause of grimacing and tachypnea. Pain after abdominal surgery can indicate complications like infection or inadequate pain management. Addressing pain is a priority to ensure the client's comfort and prevent further complications. Options A, B, and D do not address the underlying issue of pain and are therefore not the most appropriate actions. Offering a cold compress or playing music may provide temporary relief but do not address the root cause. Repositioning may help with comfort but should come after assessing and addressing the pain.