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A patient with chronic pain is prescribed a fentanyl patch. What is the most important instruction for the nurse to provide?
- A. Apply the patch to a different site each time.
- B. Change the patch every 72 hours.
- C. Avoid using additional heating pads over the patch.
- D. Remove the patch before showering.
Correct Answer: B
Rationale: The correct answer is B: Change the patch every 72 hours. Fentanyl patches are typically designed to be worn for 72 hours before being replaced to maintain consistent pain relief. Changing the patch on time helps prevent withdrawal symptoms and ensures the effectiveness of the medication.
A: Applying the patch to a different site each time is important to prevent skin irritation but is not the most crucial instruction.
C: Avoiding heating pads over the patch is important to prevent overheating and excessive absorption of the medication, but changing the patch timely is more critical.
D: Removing the patch before showering is not necessary as fentanyl patches are designed to be water-resistant.
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A client with heart failure is prescribed furosemide (Lasix). Which instruction should the nurse include in the client's teaching plan?
- A. Take the medication before bedtime.
- B. Report any weight gain of more than 2 pounds in a day.
- C. Increase your intake of high-sodium foods.
- D. Limit your fluid intake to less than 1 liter per day.
Correct Answer: B
Rationale: The correct answer is B: Report any weight gain of more than 2 pounds in a day. This instruction is crucial for a client with heart failure taking furosemide as sudden weight gain can indicate fluid retention, which can worsen heart failure. Monitoring weight daily can help detect early signs of fluid overload.
A: Taking the medication before bedtime is not a critical instruction for furosemide as it is usually taken in the morning to prevent nocturia.
C: Increasing intake of high-sodium foods contradicts the purpose of furosemide, which is a diuretic used to reduce fluid retention by promoting diuresis.
D: Limiting fluid intake to less than 1 liter per day can lead to dehydration and electrolyte imbalances, which can be harmful for a client with heart failure.
What should the nurse include in patient teaching for a patient prescribed ceftriaxone for bacterial pneumonia?
- A. Take the medication as prescribed.
- B. Expect urine color changes.
- C. Complete the full course of the antibiotic.
- D. Avoid dairy products during treatment.
Correct Answer: C
Rationale: Rationale:
Ceftriaxone is an antibiotic used for bacterial pneumonia. Completing the full course is essential to completely eradicate the infection and prevent antibiotic resistance. Taking medication as prescribed is a general principle, but not specific to this medication. Urine color changes are not associated with ceftriaxone. Dairy products do not interact with ceftriaxone.
A patient with chronic kidney disease (CKD) is prescribed calcium acetate. What is the primary purpose of this medication?
- A. Treat hyperkalemia
- B. Reduce phosphate levels
- C. Lower blood pressure
- D. Increase hemoglobin levels
Correct Answer: B
Rationale: The primary purpose of prescribing calcium acetate for a patient with CKD is to reduce phosphate levels. Calcium acetate acts as a phosphate binder, preventing the absorption of dietary phosphate in the intestines. Elevated phosphate levels in CKD can lead to complications such as mineral and bone disorders. Treating hyperkalemia (A) involves other medications like potassium binders, not calcium acetate. Lowering blood pressure (C) typically involves antihypertensive drugs. Increasing hemoglobin levels (D) is usually managed with erythropoiesis-stimulating agents in CKD patients. Therefore, option B is the correct answer for the primary purpose of prescribing calcium acetate in CKD patients.
A patient with chronic heart failure is prescribed carvedilol. What is the primary purpose of this medication?
- A. Increase cardiac output
- B. Reduce fluid retention
- C. Decrease heart rate
- D. Lower blood pressure
Correct Answer: C
Rationale: The correct answer is C: Decrease heart rate. Carvedilol is a beta-blocker that works by blocking the beta-adrenergic receptors in the heart, leading to a decrease in heart rate. This helps reduce the workload of the heart and improve its efficiency in patients with heart failure. Choice A is incorrect because carvedilol may not necessarily increase cardiac output directly. Choice B is incorrect because carvedilol focuses more on improving heart function rather than directly reducing fluid retention. Choice D is incorrect because while carvedilol may lower blood pressure as a secondary effect, its primary purpose in heart failure is to improve cardiac function by decreasing heart rate.
When should surgical correction of hypospadias typically occur for a newborn infant as advised by the nurse?
- A. Repair should be done within one month to prevent bladder infections.
- B. Repairs should typically be done before the child is potty-trained.
- C. Delaying the repair until school age reduces castration fears.
- D. To form a proper urethra repair, it should be done after sexual maturity.
Correct Answer: B
Rationale: The correct answer is B because surgical correction of hypospadias is typically recommended before the child is potty-trained. This is important for optimal cosmetic and functional outcomes, as the procedure is more straightforward in infants due to their smaller anatomy. Delaying the surgery can lead to increased risk of complications and potential psychological impact on the child as they grow older.
A: Repair within one month to prevent bladder infections is not the primary reason for early correction of hypospadias.
C: Delaying the repair to school age for reducing castration fears is not a valid reason for postponing the surgery.
D: Waiting until after sexual maturity to form a proper urethra repair is not recommended as early correction typically yields better results.