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A patient asks how to apply transdermal nitroglycerin. What is the nurse™s best response?
- A. Always apply the transdermal patch over the area of your chest where your heart is.
- B. Keep the previous patch on for 1 full day so you always have two patches on at a tim
- C.
- D. Apply the patch to hairless areas of the body.
Correct Answer: D
Rationale: Transdermal nitroglycerin patches should be applied to clean, dry, hairless areas of the body to ensure proper absorption of the medication. Hair can interfere with the absorption of the medication through the skin. Commonly recommended areas for application include the chest, upper arm, or abdomen. It is important to rotate application sites to prevent skin irritation and to follow the specific instructions provided by the healthcare provider or pharmacist.
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The nurse administers IV push hydralazine (Apresoline) to a client with severe hypertension. Which assessment finding requires immediate action?
- A. Blood pressure of 140/90 mmHg
- B. Heart rate of 110 beats per minute
- C. Headache
- D. Flushing
Correct Answer: B
Rationale: Hydralazine, a vasodilator, lowers blood pressure but triggers reflex tachycardia. A heart rate of 110 bpm indicates significant compensation, risking ischemia or strain, requiring immediate action (e.g., slowing infusion, notifying physician). BP of 140/90 is improved, not critical. Headache and flushing are expected from vasodilation, less urgent. Tachycardia's potential to destabilize circulation, especially in severe hypertension, aligns with hydralazine's pharmacology'arteriolar relaxation prompts sympathetic response. This finding demands swift intervention to prevent cardiovascular collapse, making B the priority over manageable side effects.
An adolescent client will receive Depo-Provera as a method of birth control. She asks the nurse how long the drug will be effective. What is the best response by the nurse?
- A. 2 months
- B. 6 months
- C. 1 year
- D. 3 months
Correct Answer: D
Rationale: Depo-Provera, a progestin injection, provides contraception by inhibiting ovulation for 3 months , requiring re-administration every 12 weeks. This duration is based on its pharmacokinetic profile, ensuring reliable hormone levels. Two months underestimates, risking unprotected gaps. Six months or 1 year overestimate, reducing efficacy mid-cycle. The nurse's accurate response (D) educates the client on timing, ensuring adherence and preventing unintended pregnancy, aligning with clinical standards for injectable contraceptives.
A 48-year-old woman pricks her finger on a rose bush while pruning. A few days later, she develops small, red lesions near the wound and a red track ascending her hand toward her trunk. Her doctor prescribes itraconazole for the sporotrichosis. What is the mechanism of action of this medication?
- A. Disrupts fungal cell membrane by forming pores (nystatin, amphotericin B)
- B. Disrupts fungal microtubules (griseofulvin)
- C. Inhibits conversion of lanosterol to ergosterol
- D. Inhibits squalene monooxygenase (terbinafine)
Correct Answer: C
Rationale: Sporotrichosis, from Sporothrix schenckii, requires antifungals like itraconazole. Option , inhibiting lanosterol to ergosterol conversion, is correct-itraconazole blocks 14-α-demethylase, disrupting fungal membrane synthesis. Option , pore formation, is amphotericin B's mechanism. Option , microtubule disruption, is griseofulvin's. Option , squalene monooxygenase inhibition, is terbinafine's. Option (E), 5-FU conversion, is flucytosine's. Itraconazole's ergosterol inhibition effectively treats this subcutaneous infection, targeting fungal viability.
Enteric coated acetylsalicylic acid has been prescribed for a patient to treat chronic arthritis. The patient calls the clinic nurse because of gagging and difficulty swallowing the tablets. What response would the nurse give to the patient?
- A. Crush the tablets and mix with juice or food'
- B. I’ll notify the healthcare provider for a medication change'
- C. Open the tablet and mix the contents with food'
- D. Swallow the tablets with large amounts of water or milk'
Correct Answer: D
Rationale: Enteric-coated tablets should not be crushed or opened, as this disrupts their protective coating and can cause gastric irritation. The patient should be instructed to swallow the tablets whole with plenty of water or milk. Crushing (A) or opening the tablets (C) is inappropriate. Notifying the healthcare provider (B) may be necessary if the patient cannot tolerate the medication.
What is a side effect of Heparin?
- A. nausea
- B. diarrhea
- C. bleeding
- D. bronchospasms
Correct Answer: C
Rationale: Heparin is an anticoagulant medication that works by preventing the formation of blood clots. One of the main side effects of heparin therapy is an increased risk of bleeding. Since heparin inhibits the body's ability to clot blood, it can lead to easy bruising, nosebleeds, gastrointestinal bleeding, or bleeding at the injection site. Patients on heparin therapy must be closely monitored for signs of bleeding, and their dosage may need to be adjusted to minimize this risk.