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A patient with open-angle glaucoma asks the nurse about the duration of use for the prescribed eye drops. What is the nurse’s accurate response?
- A. For long-term control of pain and swelling.
- B. Until a smaller angle can be restored.
- C. Until the excess pressure is reduced.
- D. For long-term control of normal eye pressure.
Correct Answer: D
Rationale: Open-angle glaucoma requires lifelong eye drops to maintain normal intraocular pressure (D). They don’t control pain/swelling (A) or restore angles (B). Pressure reduction (C) is ongoing, not temporary.
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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.
A patient is currently on an oral contraceptive and has been prescribed erythromycin. What advice should the nurse provide to the patient?
- A. Utilize an additional form of contraception.
- B. Immediately discontinue the oral contraceptive.
- C. Ensure a 12-hour gap between taking the medications.
- D. Avoid prolonged exposure to direct sunlight.
Correct Answer: A
Rationale: Erythromycin may reduce oral contraceptive efficacy by inducing hepatic metabolism. Using an additional contraceptive method (A) prevents unintended pregnancy. Discontinuing the contraceptive (B) is unnecessary. Timing gaps (C) don’t mitigate the interaction. Sunlight avoidance (D) relates to other antibiotics like tetracycline.
A patient in a residential treatment facility uses a fluticasone propionate and salmeterol discus inhalation system to manage asthma. This system delivers an inhaled powdered form of these combined medications. What instruction should the nurse provide to this patient’s caregivers?
- A. Instruct the patient to exhale rapidly into the mouthpiece when using the discus.
- B. Explain that the patient should not use the discus more than twice daily.
- C. Inform that patients using the discus may experience a decrease in blood pressure.
- D. Suggest offering the discus to the patient for use during an acute asthma attack.
Correct Answer: B
Rationale: Fluticasone/salmeterol is a maintenance therapy, used twice daily (B). Exhaling into the mouthpiece (A) is incorrect; inhalation is required. Hypotension (C) isn’t a common side effect. It’s not for acute attacks (D), which require rescue inhalers.
A client with type I diabetes mellitus has been prescribed a glucagon emergency kit for home use. When should the nurse instruct the client and family to administer glucagon?
- A. Prior to meals to prevent hyperglycemia.
- B. When symptoms of severe hypoglycemia are present.
- C. When the client is unable to eat during sick days.
- D. At the onset of symptoms of diabetic ketoacidosis.
Correct Answer: B
Rationale: This question is identical to Question 25. Glucagon is for severe hypoglycemia (B), not hyperglycemia (A), sick days (C), or ketoacidosis (D). Note: Duplicate question; consider removing.
After taking orlistat for one week, a female patient tells the home health nurse that she is experiencing increasingly frequent oily stools and gas. What action should the nurse take?
- A. Ask the patient to describe her dietary intake history for the last several days.
- B. Advise the patient to stop taking the drug and contact her healthcare provider.
- C. Instruct the patient to increase her intake of saturated fats over the next week.
- D. Obtain a stool specimen to evaluate for occult blood and fat content.
Correct Answer: A
Rationale: Orlistat inhibits fat absorption, causing oily stools and gas if dietary fat is high. Assessing dietary intake (A) identifies the cause. Stopping the drug (B) is premature. Increasing fats (C) worsens symptoms. Stool testing (D) is unnecessary for known side effects.