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A nurse is talking with a client who takes NSAIDs routinely to treat osteoarthritis and has a new prescription for misoprostol. The client asks the nurse why he needs the second medication. Which of the following is an appropriate response?
- A. Misoprostol will help prevent stomach ulcers, which can develop from taking NSAIDs for a long time.
- B. Misoprostol helps protect you against the effects long-term NSAID use can have on your kidney function.
- C. Misoprostol will boost the effectiveness of the NSAIDs, so you can get the same pain relief with lower dosages.
- D. Misoprostol is a very effective antacid that will help reduce the stomach irritation you can get from NSAIDs.
Correct Answer: A
Rationale: The correct answer is A because misoprostol is often prescribed along with NSAIDs to help prevent stomach ulcers that can develop from long-term NSAID use. NSAIDs can irritate the stomach lining and increase the risk of ulcers. Misoprostol works by reducing the production of stomach acid and protecting the stomach lining. Choices B, C, and D are incorrect because misoprostol is specifically used to protect the stomach from NSAID-related ulcers, not to protect kidney function, boost NSAID effectiveness, or act as an antacid.
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A nurse is reinforcing teaching with a young adult client who has a new prescription for ear drops. Which of the following instructions should the nurse include?
- A. Chill the medication prior to instillation.
- B. Press a cotton ball firmly in ear canal after administering drops.
- C. Pull the pinna up and back to administer medication.
- D. Place an applicator into the ear canal to instill drops.
Correct Answer: C
Rationale: The correct answer is C: Pull the pinna up and back to administer medication. This instruction is correct because pulling the pinna up and back helps straighten the ear canal in adults, allowing the drops to be instilled properly. This technique ensures that the medication reaches the desired target area for optimal effectiveness.
Explanation of other choices:
A: Chilling the medication is not necessary and can cause discomfort to the client.
B: Pressing a cotton ball firmly in the ear canal can prevent the drops from reaching the ear canal.
D: Placing an applicator into the ear canal can cause injury or damage to the ear canal and eardrum.
A nurse is preparing to administer an IM injection to a client who has gonorrhea. Which of the following actions should the nurse take?
- A. Inject the medication at least 5 cm (2 in) from the umbilicus.
- B. Administer the medication with a 27-gauge /0.5 inch needle.
- C. Use the Z-track technique to administer the medication.
- D. Give the medication without aspirating prior to injection.
Correct Answer: C
Rationale: The correct answer is C: Use the Z-track technique to administer the medication. The Z-track technique involves pulling the skin laterally before injecting the medication to prevent leakage and irritation. This is crucial when administering IM injections to prevent the medication from leaking into the subcutaneous tissue. Option A is incorrect because the injection site for IM injections should be at least 2.5 cm (1 inch) away from the umbilicus. Option B is incorrect because a larger needle gauge (e.g., 22-25 gauge) is typically used for IM injections to reduce discomfort and prevent medication leakage. Option D is incorrect because aspirating prior to injection is not necessary for IM injections and may cause tissue damage.
A nurse is caring for a client who has a new prescription for valproic acid. The nurse should review which of the following baseline laboratory values prior to administering the medication?
- A. Arterial blood gases
- B. Liver function tests
- C. Troponin levels
- D. Blood glucose levels
Correct Answer: B
Rationale: The correct answer is B: Liver function tests. Valproic acid is known to potentially cause hepatotoxicity, so it is essential to assess baseline liver function tests before administering the medication. Monitoring liver function tests can help identify any pre-existing liver conditions and prevent further liver damage. Arterial blood gases (A) are not directly related to valproic acid administration. Troponin levels (C) are used to assess heart muscle damage, which is not a concern with valproic acid. Blood glucose levels (D) are not specifically relevant to valproic acid therapy.
A nurse is caring for an adult client who is receiving albuterol inhalation treatments. For which of the following adverse effects should the nurse monitor the client? (Select all that apply.)
- A. Shakiness
- B. Fatigue
- C. Tinnitus
- D. Tachycardia
- E. Palpitations
Correct Answer: A, D, E
Rationale: The correct adverse effects to monitor for with albuterol inhalation treatments are shakiness, tachycardia, and palpitations. Albuterol is a beta-2 adrenergic agonist that can cause sympathetic stimulation, leading to these specific side effects. Shakiness is due to the stimulation of beta-2 receptors in muscles, tachycardia results from the activation of beta-1 receptors in the heart, and palpitations can occur due to increased heart rate. Fatigue and tinnitus are not commonly associated with albuterol use, making choices B and C incorrect. In summary, the correct answers are related to the sympathetic effects of albuterol, while the incorrect choices are not typically seen with this medication.
A nurse is reviewing the medication list of a client who has a new prescription for tetracycline. The nurse should instruct the client to take which of the following medications 3 hr before or after taking the tetracycline?
- A. Hydrochlorothiazide
- B. Antacid
- C. Acetaminophen
- D. Lovastatin
Correct Answer: B
Rationale: The correct answer is B: Antacid. Tetracycline can bind to certain substances, like calcium in antacids, reducing its absorption. By taking the antacid 3 hours before or after tetracycline, the client can ensure optimal absorption of the antibiotic. Choice A, hydrochlorothiazide, does not interact significantly with tetracycline. Choices C and D also do not have significant interactions with tetracycline.