Nokea
A patient who is taking metronidazole for the past 4 days for the treatment of a parasitic infection reports to the nurse that his most recent dose made him 'flushed, sweaty, and sick in the stomach.' What assessment is most likely to address the cause of this phenomenon?
- A. "Have you experienced any allergic reactions to metronidazole before?"
- B. "Did you drink any alcoholic beverages around the time of taking the drug?"
- C. "Did you take this dose on an empty stomach?"
- D. "Are you currently using any over-the-counter antihistamines?"
Correct Answer: B
Rationale: The correct answer is B. Metronidazole can cause a disulfiram-like reaction when taken with alcohol, leading to symptoms such as flushing, sweating, and gastrointestinal upset. Asking the patient about alcohol consumption can help identify if this reaction is due to alcohol interaction. Choice A is incorrect as it focuses on penicillin allergy, which is not relevant to metronidazole. Choice C is less likely to cause the reported symptoms and is not a common concern with metronidazole. Choice D is not directly related to the symptoms described by the patient.
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What should the nurse assess in a patient experiencing breakthrough bleeding while taking oral contraceptives?
- A. Adherence to the medication schedule
- B. The possibility of pregnancy
- C. The need for an increased dosage
- D. The effectiveness of the current oral contraceptive
Correct Answer: A
Rationale: When a patient on oral contraceptives experiences breakthrough bleeding, the nurse should assess the patient's adherence to the medication schedule. Breakthrough bleeding is often a sign of non-adherence, potentially reducing the effectiveness of the contraceptives. Assessing the adherence to the schedule helps in determining if the medication is being taken correctly. The possibility of pregnancy (choice B) is less likely if the patient has been taking the contraceptives as prescribed. Increasing the dosage (choice C) without assessing adherence first can lead to unnecessary medication adjustments. Evaluating the effectiveness of the current oral contraceptive (choice D) comes after assessing adherence to the schedule.
A patient is starting on atorvastatin (Lipitor) for hyperlipidemia. What critical instruction should the nurse provide?
- A. Take the medication at night to reduce the risk of muscle pain and other side effects.
- B. Avoid consuming grapefruit juice while taking this medication.
- C. Take the medication in the morning with breakfast to improve absorption.
- D. Take the medication with a high-fat meal to increase its effectiveness.
Correct Answer: A
Rationale: The correct answer is to take the medication at night to reduce the risk of muscle pain and other side effects. Atorvastatin, like other statins, is more effective when taken in the evening as the body produces more cholesterol at night. Taking it with a high-fat meal (choice D) is not recommended as it may reduce the drug's absorption. Grapefruit juice (choice B) should be avoided with atorvastatin as it can increase the risk of side effects. Taking the medication in the morning with breakfast (choice C) is not as effective as taking it at night.
What tool is used to determine a client's level of consciousness?
- A. Magnetic resonance imaging (MRI)
- B. Glasgow Coma Scale (GCS)
- C. Central perfusion pressure (CPP)
- D. Intracranial pressure (ICP) monitoring
Correct Answer: B
Rationale: The correct answer is B: Glasgow Coma Scale (GCS). The Glasgow Coma Scale is specifically designed to assess a client's level of consciousness by evaluating verbal, motor, and eye-opening responses. Choice A, Magnetic Resonance Imaging (MRI), is a diagnostic imaging tool that provides detailed images of the body's organs and tissues but is not used to assess consciousness levels. Choice C, Central Perfusion Pressure (CPP), and Choice D, Intracranial Pressure (ICP) monitoring, are related to hemodynamic monitoring and intracranial pressure management, not direct assessment of consciousness.
A nurse is caring for a client with lung cancer who is experiencing dyspnea. Which intervention is most appropriate?
- A. Administer a cough suppressant to reduce discomfort.
- B. Encourage the client to lie flat to ease breathing.
- C. Provide supplemental oxygen therapy.
- D. Encourage deep breathing and coughing exercises.
Correct Answer: C
Rationale: The most appropriate intervention for a client with lung cancer experiencing dyspnea is to provide supplemental oxygen therapy. This intervention helps improve oxygenation and alleviate breathing difficulties. Administering a cough suppressant (Choice A) may not address the underlying cause of dyspnea and can potentially depress the respiratory drive. Encouraging the client to lie flat (Choice B) can worsen dyspnea by reducing lung expansion. Encouraging deep breathing and coughing exercises (Choice D) may be beneficial in some situations, but when a client is experiencing dyspnea due to lung cancer, supplemental oxygen therapy is the priority to improve oxygen levels and alleviate breathing difficulty.
What condition is a result of Polycythemia Vera, which involves excess red blood cells?
- A. Tissue ischemia & necrosis
- B. Chronic pancreatitis
- C. Low blood pressure & heart rate
- D. Increased numbers of infections
Correct Answer: A
Rationale: Polycythemia Vera, characterized by excess red blood cells, can cause tissue ischemia and necrosis due to the increased blood viscosity. This condition restricts blood flow, leading to inadequate oxygen delivery to tissues and subsequent tissue damage. Choices B, C, and D are incorrect because they are not directly associated with the pathophysiology of Polycythemia Vera.