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A nurse is reinforcing teaching with a client who has angina and a new prescription of nitroglycerin sublingual. Which of the following statements by the client indicates an understanding of the teaching?
- A. If my pain is not relieved in 20 minutes, I will take a second tablet.'
- B. I will keep my tablets on a shelf in the bathroom.'
- C. I should be sure to swallow the tablet whole.'
- D. If my mouth is dry, I will take a sip of water before I take the tablet.'
Correct Answer: D
Rationale: The correct answer is D: "If my mouth is dry, I will take a sip of water before I take the tablet." This statement indicates an understanding of how to properly administer nitroglycerin sublingual. Taking the medication under the tongue allows for faster absorption. Taking a sip of water before taking the tablet helps moisten the mouth and aids in the absorption of the medication. This step is crucial for the effectiveness of nitroglycerin in relieving angina symptoms.
Other choices are incorrect:
A: Taking a second tablet before the 20-minute mark is not recommended as it can lead to an overdose.
B: Keeping tablets in the bathroom exposes them to moisture, affecting their potency.
C: Nitroglycerin sublingual should not be swallowed but dissolved under the tongue for rapid absorption.
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A nurse is reinforcing teaching with a client who has a new prescription for lithium. Which of the following information should the nurse include in the teaching?
- A. Increase fluid intake
- B. Decrease sodium intake
- C. Eat foods high in potassium
- D. Take the medication 1 hr before meals.
Correct Answer: A
Rationale: The correct answer is A: Increase fluid intake. Lithium is a medication used to treat bipolar disorder, and it can cause dehydration and increase the risk of lithium toxicity. By increasing fluid intake, the client can maintain proper hydration levels, which helps to prevent lithium toxicity. This information is crucial for the client's safety and well-being.
Incorrect choices:
B: Decrease sodium intake - While monitoring sodium intake is important with lithium therapy, decreasing it is not necessary.
C: Eat foods high in potassium - While maintaining a balanced diet is important, focusing on potassium specifically is not directly related to lithium therapy.
D: Take the medication 1 hr before meals - Lithium can be taken with or without food, so the timing of meals in relation to medication is not a critical teaching point.
A nurse is collecting data from a client before administering a hepatitis B immunization. The nurse should withhold the immunization if the client is allergic to which of the following substances?
- A. Baker's yeast
- B. Nuts
- C. Wheat
- D. Egg yolk
Correct Answer: A
Rationale: The correct answer is A: Baker's yeast. Hepatitis B vaccines are produced using baker's yeast, specifically Saccharomyces cerevisiae. If a client is allergic to baker's yeast, there is a risk of an allergic reaction to the vaccine. Nuts (B), wheat (C), and egg yolk (D) are not ingredients used in the hepatitis B vaccine production, so allergies to these substances would not necessitate withholding the immunization.
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.
Nurses' Notes
Medication Reconciliation
Medicine Prescriptions
1 week ago:
Client who was diagnosed with asthma during childhood presents to the clinic with increased night-time coughing and shortness of breath during activities of daily living. The client reports increased use of their rescue inhaler. The client has a non-productive cough and inspiratory and expiratory wheezing heard during auscultation. Client prescribed prednisone and requested to follow up in 5 to 7 days.
Today:
The client reports their asthma symptoms have improved since beginning the prednisone. Lung sounds clear with occasional wheezing. The client has gained 1.36 kg (3 lb) since the last visit. The client states they received the "flu shot" 3 days ago to avoid getting sick. The client states they hurt their back while moving the couch 5 days ago and have been taking ibuprofen twice daily since then.
Complete the following sentence by using the lists of options: The client is most at risk for developing ___ due to their ___.
- A. Cushing syndrome
- B. influenza
- C. peptic ulcers
- D. NSAID use
- E. recent immunization
- F. weight gain
Correct Answer: C,D
Rationale:
The correct answer is C,D because the client is at risk for developing peptic ulcers due to NSAID use. NSAIDs can cause irritation and damage to the stomach lining, leading to peptic ulcers. The other options, such as Cushing syndrome (A), influenza (B), recent immunization (E), and weight gain (F), are not directly related to the client's risk of developing peptic ulcers due to NSAID use.
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.