A patient with glaucoma is prescribed timolol eye drops. What is the primary action of this medication?
- A. Reduce intraocular pressure
- B. Dilate the pupils
- C. Constrict the pupils
- D. Enhance tear production
Correct Answer: A
Rationale: The correct answer is A: Reduce intraocular pressure. Timolol is a beta-blocker that works by decreasing the production of aqueous humor in the eye, thereby reducing intraocular pressure. This action helps to prevent damage to the optic nerve in patients with glaucoma. Choices B and C are incorrect because timolol does not affect pupil size. Choice D is incorrect because timolol does not enhance tear production; in fact, it may have a drying effect on the eyes.
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Which signs or symptoms are characteristic of an adult client diagnosed with Cushing's syndrome?
- A. Husky voice and complaints of hoarseness.
- B. Warm, soft, moist, salmon-colored skin.
- C. Visible swelling of the neck, with no pain.
- D. Central-type obesity, with thin extremities.
Correct Answer: D
Rationale: The correct answer is D because central-type obesity with thin extremities is a classic characteristic of Cushing's syndrome due to excess cortisol. This pattern of weight distribution is caused by cortisol's impact on fat metabolism and distribution. A is incorrect because a husky voice and hoarseness are not typical symptoms of Cushing's syndrome. B is incorrect as warm, soft, moist, salmon-colored skin is not a common finding in Cushing's syndrome. C is incorrect because visible swelling of the neck without pain is not a typical sign of Cushing's syndrome.
When assessing a male client who is receiving a unit of packed red blood cells (PRBCs), the nurse notes that the infusion was started 30 minutes ago, and 50 ml of blood is left to be infused. The client's vital signs are within normal limits. He reports feeling 'out of breath' but denies any other complaints. What action should the nurse take at this time?
- A. Administer a PRN prescription for diphenhydramine (Benadryl).
- B. Start the normal saline attached to the Y-tubing at the same rate.
- C. Decrease the intravenous flow rate of the PRBC transfusion.
- D. Ask the respiratory therapist to administer PRN albuterol (Ventolin).
Correct Answer: C
Rationale: The correct action for the nurse to take in this situation is to decrease the intravenous flow rate of the PRBC transfusion. The client is showing early signs of a transfusion reaction, as evidenced by feeling 'out of breath'. By decreasing the flow rate of the transfusion, the nurse can slow down the rate at which the remaining blood is infused, potentially preventing a more severe reaction. Administering diphenhydramine or albuterol would not address the underlying issue of a potential transfusion reaction. Starting normal saline at the same rate may exacerbate the client's symptoms and is not indicated in this scenario.
What instruction should the nurse give regarding the administration of alendronate to a patient with osteoporosis?
- A. Take the medication with milk.
- B. Lie down for 30 minutes after taking the medication.
- C. Take the medication with a full glass of water.
- D. Take the medication before bedtime.
Correct Answer: C
Rationale: The correct answer is C: Take the medication with a full glass of water. Alendronate should be taken with a full glass of water on an empty stomach in the morning to enhance absorption. Option A is incorrect because taking alendronate with milk decreases its absorption. Option B is incorrect as lying down after taking alendronate can lead to esophageal irritation. Option D is incorrect because taking the medication before bedtime can cause esophageal irritation as well due to the risk of reflux when lying down.
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.
A patient with bipolar disorder is prescribed valproic acid. What is an important side effect for the nurse to monitor?
- A. Hypertension
- B. Liver toxicity
- C. Hyperglycemia
- D. Bradycardia
Correct Answer: B
Rationale: Correct Answer: B (Liver toxicity)
Rationale:
1. Valproic acid is known to cause liver toxicity.
2. The nurse should monitor liver function tests regularly.
3. Signs of liver toxicity include jaundice, abdominal pain, and nausea.
4. Prompt detection is crucial to prevent serious complications.
Summary:
A: Hypertension - Not a common side effect of valproic acid.
C: Hyperglycemia - More commonly associated with other medications like antipsychotics.
D: Bradycardia - Not a typical side effect of valproic acid.
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