Nokea
A nurse teaching a patient with COPD pulmonary exercises should do which of the following?
- A. Teach pursed-lip breathing techniques.
- B. Encourage repetitive heavy lifting exercises that will increase strength.
- C. Limit exercises based on respiratory acidosis.
- D. Take breaks every 10-20 minutes with exercises.
Correct Answer: A
Rationale: Pursed-lip breathing will help decrease the volume of air expelled by increased bronchial airways.
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Trimethoprim-sulfamethoxazole is prescribed for the child who develops a UTI. What information should the nurse address when teaching the parents about administering the medication? Select all that apply.
- A. Weigh the child daily in the morning.
- B. Take the child's temperature once daily.
- C. Encourage the child to drink plenty of fluids.
- D. Administer the medication at the prescribed times.
- E. If a rash occurs, report this immediately to the HCP.
Correct Answer: C,D,E
Rationale: A: Weighing is unnecessary; it is important with medications that affect fluid balance, but not with an antibiotic. B: Monitoring temperature would be important to evaluate the effectiveness of antipyretic medications. C: Fluids should be increased to dilute bacterial toxins and increase urinary output. D: The medication should be given in the exact amount at the times directed to maintain a therapeutic blood level. If the therapeutic blood level falls, organisms can build a resistance to the medication. E: Trimethoprim-sulfamethoxazole (Bactrim) is a sulfonamide antibiotic. A rash can indicate an allergy to sulfonamides.
The client taking carbamazepine XR for seizure control reports that pieces of the medication are being passed into the stool. Which action by the nurse is most important?
- A. Report this to the health care provider.
- B. Reassure the client that this is normal.
- C. Collect the stool for laboratory analysis.
- D. Document the findings in the medical record.
Correct Answer: B
Rationale: A: It is inappropriate to report an expected finding to the HCP. B: Carbamazepine XR (Tegretol XR) is a sustained-release medication with a coating that is not absorbed but is excreted in feces and may be visible in stool. The nurse should reassure the client that this is normal. C: Collecting the stool for laboratory analysis is not necessary because the coating is not absorbed but excreted in the stool. D: The nurse should document the client teaching but usually would not document the presence of the coating in the client's stool.
The nurse is preparing to administer a pm dose of benztropine to the client with worsening akathisia. The client's medication record lists benztropine 0.5 mg IM q4h pm. The vial contains 1 mg/mL. How many milliliters of the medication should the nurse administer?
Correct Answer: 0.5
Rationale: Calculation: 0.5 mg/ 1 mg/mL = 0.5 mL.
The nurse administered phenylephrine eye drops to the client before performing an ophthalmoscopic eye examination. Which assessment finding should the nurse expect?
- A. Tremor
- B. Hypotension
- C. Pupil miosis
- D. Pupil mydriasis
Correct Answer: D
Rationale: A: Tremors are a side effect if phenylephrine is absorbed systemically. B: Because phenylephrine absorbed systemically is a vasoconstrictor, hypertension (not hypotension) can occur as a side effect. C: Miosis is pupil constriction, not an effect of phenylephrine. D: Phenylephrine (NeoSynephrine), an adrenergic agonist, produces pupil dilation (mydriasis) by activating alpha1-adrenergic receptors on the dilator muscles of the iris.
The LPN is admitting a client to the unit and the client has rapidly blinking eyes, stuck out tongue, and a distorted posture. Which of these medications is the patient most likely taking?
- A. Clozapine
- B. Fluoxetine
- C. Ondansetron
- D. Haloperidol
Correct Answer: D
Rationale: Haloperidol is a first-generation antipsychotic that blocks dopamine receptors and is most likely to cause extrapyramidal symptoms (EPS), such as tardive dyskinesia. Symptoms of tardive dyskinesia include rapid blinking, mouth movements, sticking out of the tongue, rapid body movements, and a distorted posture.