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A patient with nasal congestion has been prescribed phenylephrine 10 mg by mouth every 4 hours. What patient condition should the nurse report to the healthcare provider before administering the medication?
- A. Hypertension.
- B. Bronchitis.
- C. Diarrhea.
- D. Edema.
Correct Answer: A
Rationale: Phenylephrine, a decongestant, can raise blood pressure, making hypertension (A) a contraindication requiring provider consultation. Bronchitis (B), diarrhea (C), and edema (D) are not directly affected by phenylephrine.
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A client has a new prescription for zolpidem, a hypnotic. The client tells the home health nurse that he plans to take a dose of the medication during the day because he is exhausted and needs to take a short afternoon nap prior to an evening activity in his home. Which action should the nurse take?
- A. Explain that the client needs to allow for sleep time of at least two hours.
- B. Advise the client to take the medication with the noon meal.
- C. Encourage the client to wait until bedtime to take the medication.
- D. Remind the client to drink plenty of fluids when taking the medication.
Correct Answer: C
Rationale: Zolpidem, a sedative-hypnotic, should be taken at bedtime (C) to avoid daytime drowsiness and fall risk. Two hours of sleep (A) is insufficient for safe clearance. Taking with meals (B) reduces efficacy. Fluid intake (D) is unrelated to zolpidem’s administration.
An elderly client with heart failure arrives at the emergency room due to nausea, vomiting, and anorexia. Based on the client’s signs and symptoms, which piece of data from the medical history is most significant when planning this client’s care?
- A. The client underwent a coronary artery bypass procedure in 1995.
- B. The client had a colonoscopy performed for routine screening six months ago.
- C. The client suffered from depression following the death of their spouse in 1999.
- D. The client has been taking digoxin and furosemide daily since 1996.
Correct Answer: D
Rationale: Digoxin and furosemide (D) can cause nausea, vomiting, and anorexia due to toxicity (digoxin) or electrolyte imbalances (furosemide), critical for heart failure management. Past bypass (A), colonoscopy (B), and depression (C) are less relevant to current symptoms.
A patient with heart failure develops hyperaldosteronism and is prescribed spironolactone. What instructions should the nurse include in the patient’s care plan?
- A. Substitute salt with a salt substitute.
- B. Protect your skin before going outside.
- C. Limit intake of high-potassium foods.
- D. Monitor skin for excessive bruising.
Correct Answer: C
Rationale: This question is identical to Question 7. Spironolactone increases potassium retention, so limiting high-potassium foods (C) prevents hyperkalemia. Salt substitutes (A) contain potassium. Sun protection (B) and bruising (D) are unrelated. Note: Duplicate question; consider removing.
The nurse is administering the muscle relaxant baclofen orally to a patient diagnosed with multiple sclerosis. What intervention should the nurse implement?
- A. Advise the patient to move slowly and cautiously when getting up and walking.
- B. Evaluate the patient’s muscle strength every 4 hours.
- C. Monitor the patient’s intake and output every 8 hours.
- D. Ensure the patient understands to stop taking baclofen before using other antispasmodics.
Correct Answer: A
Rationale: Baclofen causes drowsiness and weakness, increasing fall risk. Advising slow, cautious movement (A) enhances safety. Muscle strength checks (B) and intake/output (C) are less critical. Abruptly stopping baclofen (D) risks withdrawal (e.g., seizures), not advised.
Rivastigmine, a cholinesterase inhibitor, is prescribed for a female patient with early-stage Alzheimer’s Disease. The patient’s daughter tells the nurse that she plans to start administering the drug when her mother’s symptoms worsen, hoping to avoid nursing home placement. How should the nurse respond?
- A. Affirm the decision to use the medication when the symptoms start to worsen.
- B. Explain that the drug should be used early in the disease process.
- C. Assess the patient’s current mental status before deciding to support the decision.
- D. Confirm that the daughter is aware of the progressive nature of the disease.
Correct Answer: B
Rationale: Rivastigmine is most effective early in Alzheimer’s (B) to slow symptom progression. Delaying until worsening (A) reduces benefits. Mental status assessment (C) informs but doesn’t guide timing. Discussing disease progression (D) is secondary to medication timing.