Nokea
A nurse is reinforcing teaching with a client who has COPD and has been taking long-term high doses of prednisone. Which of the following instructions should the nurse include in the teaching?
- A. Limit potassium-containing foods in your diet.'
- B. Withhold prednisone for 48 hours prior to receiving contrast dye.'
- C. Measure your blood glucose levels periodically.'
- D. Take prednisone on an empty stomach.'
Correct Answer: C
Rationale: The correct answer is C: Measure your blood glucose levels periodically. Clients taking long-term high doses of prednisone are at risk for developing steroid-induced diabetes due to the drug's effect on blood glucose levels. Monitoring blood glucose levels will help detect any abnormalities early, allowing for timely intervention.
A: Limiting potassium-containing foods is not directly related to prednisone use in COPD.
B: Withholding prednisone for 48 hours prior to receiving contrast dye can lead to adrenal insufficiency in clients on long-term prednisone therapy.
D: Taking prednisone on an empty stomach is not a specific instruction related to managing COPD or prednisone therapy.
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Vital Signs
History and Physical
Assessment
Laboratory Results
Provider Prescriptions
Yesterday:
Temperature 37.4° C (99.3° F)
Heart rate 92/min
Respiratory rate 18/min
Blood pressure 130/82 mm Hg
Oxygen saturation 97% on room air
Today:
Temperature 38.9° C (102° F) Heart rate 110/min
Respiratory rate 18/min
Blood pressure 138/88 mm Hg
Oxygen saturation 96% on room air
The nurse has reviewed the client's electronic medical record (EMR). Which of the following findings should the nurse recommend withholding the ceftriaxone? Select all that apply.
- A. Breastfeeding
- B. Client allergy
- C. Gentamycin prescription
- D. Hematocrit
- E. Hemoglobin
Correct Answer: B,C
Rationale: The correct answers are B and C.
B: Withholding ceftriaxone is recommended if the client has an allergy to it to prevent an allergic reaction.
C: Gentamicin can interact with ceftriaxone, leading to potential adverse effects.
Incorrect choices:
A: Breastfeeding is not a contraindication for ceftriaxone use.
D and E: Hematocrit and hemoglobin levels are not directly related to the administration of ceftriaxone.
A charge nurse is evaluating a newly licensed nurse caring for a client who is using a PCA device. Which of the following actions by the nurse requires intervention by the charge nurse?
- A. The nurse monitors the client for oversedation
- B. The nurse reassures the client that the PCA device will not cause an overdose
- C. The nurse asks the client to demonstrate dose delivery.
- D. The nurse administers a PCA dose for the client.
Correct Answer: D
Rationale: Correct Answer: D. The nurse administering a PCA dose for the client requires intervention. This is because only the client should be allowed to self-administer medication via a PCA device to ensure safety and prevent medication errors. Allowing the nurse to administer the dose goes against the principles of PCA therapy, which empowers the client to manage their pain relief within safe limits.
Choice A: Monitoring the client for oversedation is a standard nursing practice and does not require intervention.
Choice B: Reassuring the client about the PCA device is important for patient education but does not require immediate intervention.
Choice C: Asking the client to demonstrate dose delivery is a proactive approach to ensure the client understands how to use the device correctly and does not require intervention unless the client is unable to demonstrate understanding.
A nurse is collecting a medication history from the parent of a preschooler who comes to the clinic for routine immunizations. For which of the following findings should the nurse withhold the varicella immunization?
- A. A pregnant parent
- B. Receiving treatment for leukemia
- C. Taking acetaminophen for mild discomfort
- D. An allergy to eggs
Correct Answer: B
Rationale: The correct answer is B: Receiving treatment for leukemia. This is because individuals with leukemia have weakened immune systems, making them more susceptible to infections. Administering a live vaccine like varicella could potentially cause severe complications in these individuals.
Incorrect choices:
A: A pregnant parent - Pregnancy is not a contraindication for varicella vaccine.
C: Taking acetaminophen for mild discomfort - Acetaminophen does not interfere with varicella vaccine.
D: An allergy to eggs - Varicella vaccine is made using gelatin, not eggs, so egg allergy is not a contraindication.
A nurse is caring for a client who is taking alendronate to treat osteoporosis. The nurse should monitor for which of the following adverse effects?
- A. Drowsiness
- B. Dyskinesia
- C. Musculoskeletal pain
- D. Weight gain
Correct Answer: C
Rationale: The correct answer is C: Musculoskeletal pain. Alendronate is a bisphosphonate used to treat osteoporosis. It can cause musculoskeletal pain as a common adverse effect due to its impact on bone turnover. Monitoring for this adverse effect is essential to ensure patient safety. Drowsiness (A), dyskinesia (B), and weight gain (D) are not typically associated with alendronate use, making them incorrect choices. It is important to focus on the specific pharmacological effects and common adverse reactions of medications to determine the correct answer.
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.