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A patient has been taking Sertraline (Zoloft) 20mg/ml oral concentrate 1ml daily for several weeks and reports being unable to sleep well. What will the nurse do next?
- A. Ask the patient what time of day the medication is taken.
- B. Recommend asking the provider about weekly dosage.
- C. Counsel the patient to take the medication at bedtime.
- D. Suggest that the patient request a lower dose.
Correct Answer: A
Rationale: The correct answer is A: Ask the patient what time of day the medication is taken. This is because insomnia can be a common side effect of sertraline, and taking it at a different time of day may help alleviate this issue. By understanding the timing of the medication intake, the nurse can assess if adjusting the administration time may improve the patient's sleep. Option B is not directly related to addressing the sleep concern. Option C may help but does not address the timing issue. Option D is premature without assessing the current timing.
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A nurse is caring for a newly admitted patient who will receive Digoxin to treat cardiac dysrhythmia. The patient takes hydrochlorothiazide and reports regular use of OTC laxatives. Before administering the first dose of Digoxin, the nurse will review the patient's electrolyte levels with careful attention to which electrolytes?
- A. Calcium and magnesium.
- B. Potassium and chloride.
- C. Potassium and magnesium.
- D. Sodium and calcium.
Correct Answer: C
Rationale: The correct answer is C: Potassium and magnesium. Digoxin can cause toxicity in patients with low potassium or low magnesium levels, which can be exacerbated by the use of hydrochlorothiazide and OTC laxatives. Monitoring potassium and magnesium levels is crucial to prevent adverse effects such as cardiac dysrhythmias. Calcium and magnesium (choice A) are important electrolytes, but potassium is more critical in the context of Digoxin therapy. Potassium and chloride (choice B) are both important electrolytes, but magnesium should also be monitored. Sodium and calcium (choice D) are not the most relevant electrolytes to monitor in this situation.
The nurse is preparing to administer a medication from a multi-dose bottle. The label is torn and soiled, but the name of the medication is still readable. What is the nurse's priority action?
- A. Administer the medication if the name of the drug can be clearly read.
- B. Discard the entire bottle and contents and obtain a new bottle.
- C. Ask another nurse to verify the contents of the bottle.
- D. Find the drug information and make a new label for the bottle.
Correct Answer: B
Rationale: The correct answer is B: Discard the entire bottle and contents and obtain a new bottle. The nurse's priority is patient safety. A torn and soiled label increases the risk of administering the wrong medication, dosage, or route. Discarding the bottle ensures that the correct medication is given, preventing potential harm to the patient. Administering the medication with a damaged label poses a significant risk of medication error. Asking another nurse to verify or making a new label does not eliminate the risk associated with using a compromised bottle. Finding drug information for a new label may introduce inaccuracies. Prioritizing patient safety by obtaining a new bottle is the best course of action in this situation.
The nurse is caring for a patient that has seizure disorder. The nurse notes that the patient has reddened gums that bleed when oral care is given. The nurse recognizes this finding as:
- A. A sign of poor self-care.
- B. A drug interaction with aspirin.
- C. An adverse effect of the phenytoin.
- D. A symptom of hepatotoxicity.
Correct Answer: C
Rationale: The correct answer is C: An adverse effect of phenytoin. Phenytoin is an antiepileptic drug known to cause gingival hyperplasia, leading to reddened and bleeding gums. This is a common side effect of phenytoin due to its effect on gingival tissues. Poor self-care (choice A) may contribute to gingival issues, but in this case, the patient's gums are affected by a medication side effect. There is no indication in the question of aspirin use (choice B) or hepatotoxicity (choice D) causing the gum issues. Therefore, the most likely explanation is the adverse effect of phenytoin.
A 70-year-old patient has just received a drug that can cause sedation. What would be the priority nursing diagnosis for this patient?
- A. Deficient Knowledge, unfamiliar with drug therapy.
- B. Ineffective health maintenance, need for medication.
- C. Risk for injury, related to adverse effect of the drug.
- D. Noncompliance, cost of the drug.
Correct Answer: C
Rationale: The correct answer is C: Risk for injury, related to adverse effect of the drug. This is the priority nursing diagnosis because the patient, being 70 years old and receiving a sedating drug, is at an increased risk for falls and other injuries due to sedation. It is crucial for the nurse to monitor the patient closely for signs of sedation and take appropriate measures to prevent potential harm.
Choice A (Deficient Knowledge) is not the priority as the immediate concern is the risk of injury. Choice B (Ineffective health maintenance) focuses on the need for medication, not the potential risk of injury. Choice D (Noncompliance) is not relevant in this situation as it pertains to the cost of the drug, not the immediate safety of the patient.
The nurse is caring for a 27-year-old African American woman who was just prescribed an ACE inhibitor for the management of her hypertension. What should be advised related to contraception?
- A. No special precautions need to be taken.
- B. The use of spermicidal jellies is recommended.
- C. The minipill is the contraceptive of choice.
- D. Use barrier contraception to prevent pregnancy while taking these drugs.
Correct Answer: D
Rationale: The correct answer is D: Use barrier contraception to prevent pregnancy while taking these drugs. ACE inhibitors are contraindicated during pregnancy as they can cause harm to the fetus. Therefore, advising the patient to use barrier contraception is essential to prevent pregnancy while on this medication. Choice A is incorrect because special precautions are indeed needed. Choice B is incorrect as spermicidal jellies do not provide effective contraception on their own. Choice C is incorrect as the minipill may not be sufficient to prevent pregnancy while on ACE inhibitors.