Nokea
A nurse is teaching a client who has angina a new prescription for sublingual nitroglycerin tablets. Which of the following instructions should the nurse include in the teaching?
- A. Discard any tablets you do not use every 6 months.
- B. Take one tablet each morning 30 minutes prior to eating.
- C. Keep the tablets at room temperature in their original glass bottle.
- D. Place the tablet between your cheek and gum to dissolve.
Correct Answer: C
Rationale: The correct answer is C: Keep the tablets at room temperature in their original glass bottle. Nitroglycerin tablets are sensitive to light, moisture, and heat. Storing them in their original glass bottle at room temperature helps maintain their potency. Discarding unused tablets every 6 months (choice A) is not necessary as long as they are stored properly. Taking a tablet each morning (choice B) is not recommended as nitroglycerin is usually taken as needed for angina attacks. Placing the tablet between cheek and gum (choice D) is not the correct administration route for sublingual nitroglycerin, as it should be placed under the tongue for rapid absorption.
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A nurse is assessing a client who has hypermagnesemia. Which of the following medications should the nurse prepare to administer?
- A. Protamine sulfate
- B. Acetylcysteine
- C. Calcium gluconate
- D. Flumazenil
Correct Answer: C
Rationale: The correct answer is C: Calcium gluconate. In hypermagnesemia, there is an excess of magnesium in the blood, leading to muscle weakness, cardiac arrhythmias, and respiratory depression. Calcium gluconate is the antidote for hypermagnesemia as it works by antagonizing the effects of magnesium. By administering calcium gluconate, the nurse can help reverse the symptoms associated with hypermagnesemia and restore normal calcium levels in the body. Protamine sulfate (Choice A) is used to reverse the effects of heparin, acetylcysteine (Choice B) is used as an antidote for acetaminophen overdose, and flumazenil (Choice D) is used to reverse the effects of benzodiazepines. These medications are not indicated for hypermagnesemia.
A nurse is caring for a client who has a prescription for total parenteral nutrition (TPN). Which of the following routes of administration should the nurse use?
- A. Subcutaneous
- B. Intravenous
- C. Central venous access device
- D. Midline catheter
Correct Answer: C
Rationale: The correct answer is C: Central venous access device. TPN is a highly concentrated solution that provides all the nutrients a person needs intravenously. A central venous access device allows for the infusion of TPN into a large central vein, such as the superior vena cava, ensuring immediate access to the bloodstream for rapid absorption. Using other routes like subcutaneous (A), intravenous (B), or midline catheter (D) may not be suitable due to the high osmolarity of TPN, which can cause irritation and damage to smaller veins. Therefore, a central venous access device is the most appropriate and safe route for administering TPN.
A nurse is preparing to administer the initial dose of penicillin G IM to a client. The nurse should monitor for which of the following as an indication of an allergic reaction following the injection?
- A. Urticaria
- B. Bradycardia
- C. Pallor
- D. Dyspepsia
Correct Answer: A
Rationale: The correct answer is A: Urticaria. Urticaria, or hives, is a classic sign of an allergic reaction. It presents as raised, red, itchy welts on the skin. This occurs due to histamine release in response to the allergen (penicillin in this case). Monitoring for urticaria is crucial as it indicates a potentially serious allergic reaction that may progress to anaphylaxis. Bradycardia (B), Pallor (C), and Dyspepsia (D) are not typically associated with allergic reactions to penicillin. Bradycardia is a slow heart rate, pallor is paleness of the skin, and dyspepsia is indigestion. These symptoms are more likely related to other conditions or side effects rather than an allergic reaction.
Which of the following statements should the nurse include in the teaching about the new medication?
- A. You should take this medication with dairy products.
- B. This medication may cause constipation.
- C. It is common to experience headache or blurred vision while taking this medication.
- D. You should avoid the sun while taking this medication.
- E. You should use an alternate method of birth control while taking this medication.
Correct Answer: D
Rationale: The correct answer is D: You should avoid the sun while taking this medication. This is important because some medications can increase sensitivity to sunlight, leading to sunburn or skin reactions. Avoiding the sun can prevent these adverse effects.
A: You should not take this medication with dairy products as it may interfere with the absorption of the medication.
B: Constipation is a common side effect of some medications, but it is not specific to this particular medication.
C: Headache or blurred vision may occur with some medications, but it is not specific to this particular medication.
E: Using an alternate method of birth control may be necessary if the medication interferes with hormonal contraceptives, but this information is not provided in the question stem.
A nurse is assessing a client who reports taking over-the-counter antacids. Which of the following findings should the nurse identify as a manifestation of hypercalcemia?
- A. Constipation
- B. Decreased urine output
- C. Positive Trousseau's sign
- D. Headache
Correct Answer: A
Rationale: The correct answer is A: Constipation. Hypercalcemia can result from excessive intake of antacids containing calcium carbonate. High levels of calcium in the blood can lead to constipation due to its inhibitory effect on smooth muscle contraction in the intestinal tract. Decreased urine output (choice B) is more indicative of dehydration or renal issues. Positive Trousseau's sign (choice C) is associated with hypocalcemia, not hypercalcemia. Headache (choice D) is a nonspecific symptom and not a typical manifestation of hypercalcemia.