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A nurse is reinforcing teaching with a client who has a prescription for alendronate. Which of the following statements by the client indicates an understanding of the teaching?
- A. I will drink orange juice when I take this medication.
- B. I will remain seated for 30 minutes after I take my medication.
- C. I will take this medication right before I go to bed.
- D. I can take this medication just once a month.
Correct Answer: C
Rationale: The correct answer is C: "I will take this medication right before I go to bed." Alendronate should be taken on an empty stomach, in the morning, at least 30 minutes before the first food, drink, or medication of the day. Taking it before bed ensures the client has an empty stomach. Choice A is incorrect because orange juice can interfere with alendronate absorption. Choice B is incorrect as sitting upright for 30 minutes after taking the medication is the recommended action. Choice D is incorrect as alendronate is typically taken weekly, not monthly.
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A nurse is reinforcing teaching with a client who has diabetes mellitus and takes insulin glargine and insulin aspart. Which of the following actions indicates that the client understands the instructions?
- A. The client administers insulin glargine at the same time every day.
- B. The client mixes insulin aspart and insulin glargine in the same syringe.
- C. The client administers insulin aspart 30 min before breakfast.
- D. The client stores open vials of insulin glargine at room temperature for 60 days.
Correct Answer: A
Rationale: The correct answer is A. Administering insulin glargine at the same time every day helps maintain consistent blood sugar levels due to its long-acting nature. Mixing insulin aspart and glargine is incorrect as they have different onset and duration of action. Administering insulin aspart 30 min before breakfast may not align with the client's meal timing. Storing open vials of insulin glargine at room temperature for 60 days exceeds the recommended storage duration, risking potency and efficacy.
A nurse is collecting data from a client who was taking oxycodone four times a day for chronic pain and reports discontinuing the medication 10 days ago. Which of the following findings should the nurse expect?
- A. Hypotension
- B. Constricted pupils
- C. Insomnia
- D. Constipation
Correct Answer: C
Rationale: The correct answer is C: Insomnia. When a client discontinues oxycodone, a narcotic analgesic, they may experience withdrawal symptoms such as insomnia due to the abrupt cessation of the medication affecting the central nervous system. Hypotension (A) is not typically a withdrawal symptom of oxycodone. Constricted pupils (B) are a sign of opioid intoxication, not withdrawal. Constipation (D) is a common side effect of opioid use but is not a typical withdrawal symptom in this scenario.
A nurse is preparing to administer amoxicillin 75 mg/kg/day divided equally every 8 hr to a child who weighs 20 kg. Available is amoxicillin oral suspension 250 mg/5 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: 10 mL
Rationale: To calculate the dose, first, determine the total daily dose: 75 mg/kg/day x 20 kg = 1500 mg/day. Then, divide this by the number of doses per day (3) to get 500 mg per dose. Next, convert this to mL using the concentration of the oral suspension (250 mg/5 mL). 500 mg ÷ 250 mg/5 mL = 10 mL. Therefore, the correct answer is 10 mL.
Choice A is incorrect as it doesn't follow the correct calculation steps. Choices B-G are incorrect as they do not accurately calculate the correct dose based on the child's weight and the concentration of the oral suspension.
A nurse is reviewing the allergies of a client who has rheumatoid arthritis prior to administering celecoxib to the client. The nurse should identify that which of the following allergies is a contraindication for receiving this medication?
- A. Sulfonamides
- B. Shellfish
- C. Fluoroquinolones
- D. Peanuts
Correct Answer: A
Rationale: The correct answer is A: Sulfonamides. Celecoxib is a nonsteroidal anti-inflammatory drug (NSAID) and belongs to the class of sulfonamides. Patients allergic to sulfonamides are at risk of cross-reactivity with celecoxib, leading to severe allergic reactions. Shellfish (B), fluoroquinolones (C), and peanuts (D) are not related to the mechanism of action or composition of celecoxib, so they are not contraindications. It is important for the nurse to identify sulfonamide allergies to prevent adverse reactions in patients receiving celecoxib.
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. Neutralized gastric acid
- C. Increased WBC count
- D. Reduced bronchial inflammation
Correct Answer: D
Rationale: The correct answer is D: Reduced bronchial inflammation. Montelukast is a leukotriene receptor antagonist used to manage asthma and allergic rhinitis by reducing inflammation and bronchoconstriction in the airways. This improves breathing and reduces symptoms. Option A is incorrect as montelukast does not affect peripheral vasodilation. Option B is incorrect as it does not neutralize gastric acid. Option C is incorrect as montelukast does not affect white blood cell count. In summary, montelukast's main therapeutic effect is reducing bronchial inflammation, making option D the correct choice.