A nurse is reviewing a client's medication regimen. Which of the following medications places the client at increased risk for digoxin toxicity?
- A. Calcium channel blockers
- B. Potassium-sparing diuretics
- C. Beta blockers
- D. Loop diuretics
Correct Answer: D
Rationale: The correct answer is D, Loop diuretics. Loop diuretics can lead to hypokalemia, which increases the risk for digoxin toxicity. Loop diuretics cause potassium loss, and hypokalemia can potentiate the toxic effects of digoxin. Choices A, B, and C are incorrect because calcium channel blockers, potassium-sparing diuretics, and beta blockers do not directly increase the risk of digoxin toxicity.
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A client has been prescribed metoclopramide. Which of the following should the nurse include in client education regarding this medication?
- A. Notify your provider if you experience restlessness or spasms of the face or neck
- B. This medication can cause insomnia
- C. Decrease your fluid intake while taking this medication
- D. This medication can cause urinary frequency
Correct Answer: A
Rationale: The correct answer is A: 'Notify your provider if you experience restlessness or spasms of the face or neck.' Metoclopramide can lead to extrapyramidal symptoms such as restlessness or facial spasms, which are serious and require immediate medical attention. Choices B, C, and D are incorrect. Insomnia is not a common side effect of metoclopramide. Increasing fluid intake is usually recommended to prevent dehydration caused by potential side effects like diarrhea. Urinary frequency is not a typical side effect associated with metoclopramide.
A nurse is caring for a client prescribed montelukast. Which of the following should the nurse include in teaching related to this medication?
- A. Advise the client to take the medication once daily at bedtime
- B. This medication is for the acute management of asthma
- C. Avoid dairy products while taking this medication
- D. If the client forgets to take the medication for a few days, he should not double up on doses to catch up
Correct Answer: A
Rationale: The correct answer is to advise the client to take montelukast once daily at bedtime to maintain therapeutic effects. Choice B is incorrect because montelukast is not typically used for acute asthma management but for chronic treatment. Choice C is incorrect as there are no known interactions between montelukast and dairy products. Choice D is incorrect as it is not safe to double up on doses if the client forgets to take the medication; the missed dose should be skipped and the regular dosing schedule maintained.
A nurse is preparing to administer furosemide to a client. Which of the following findings indicates the client may be at risk for an adverse effect of the medication?
- A. Hypertension
- B. Hypokalemia
- C. Increased urine output
- D. Hyperglycemia
Correct Answer: B
Rationale: The correct answer is B: Hypokalemia. Furosemide is a loop diuretic that can cause potassium depletion, leading to hypokalemia, which is a common adverse effect. Hypokalemia can result in serious complications like cardiac arrhythmias. Choices A, C, and D are not directly associated with the adverse effects of furosemide. Hypertension is a condition that furosemide is often used to treat, increased urine output is an expected effect of furosemide, and hyperglycemia is not a typical adverse effect of this medication.
A healthcare provider is preparing to administer a measles, mumps, and rubella (MMR) vaccine to an adult client. Which of the following is a contraindication to this vaccine?
- A. The possibility of pregnancy within 4 weeks
- B. Client allergy to strawberries
- C. Client history of genital herpes
- D. The possibility of overseas travel in the next month
Correct Answer: A
Rationale: The correct answer is A. Pregnancy or the possibility of pregnancy within 4 weeks is a contraindication for receiving the MMR vaccine. Choice B, client allergy to strawberries, is not a contraindication to the MMR vaccine. Choice C, client history of genital herpes, is not a contraindication for the MMR vaccine. Choice D, the possibility of overseas travel in the next month, is not a contraindication to the MMR vaccine.
A nurse is administering metformin to a client with type 2 diabetes. Which of the following adverse effects should the nurse monitor for in this client?
- A. Diarrhea
- B. Hyperglycemia
- C. Hypoglycemia
- D. Lactic acidosis
Correct Answer: D
Rationale: The correct answer is D, Lactic acidosis. Lactic acidosis is a rare but serious adverse effect of metformin use. Metformin is not known to cause hyperglycemia or hypoglycemia. Diarrhea is a common gastrointestinal side effect of metformin but is not as serious as lactic acidosis, which requires immediate medical attention.
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