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A patient with peptic ulcer disease has been prescribed cimetidine. Which statement made by the patient indicates the need for further instruction by the nurse?
- A. Decrease cigarette use to a pack per day.
- B. Notify the healthcare provider of lethargy.
- C. Take the medication an hour after antacids.
- D. Monitor for any signs of sexual dysfunction.
Correct Answer: C
Rationale: Cimetidine should be taken with meals or immediately after, not 1 hour after antacids (C), which interferes with absorption. Reducing smoking (A) is insufficient; cessation is ideal. Lethargy (B) and sexual dysfunction (D) are valid monitoring points.
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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 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 female patient with multiple sclerosis reports less fatigue and improved memory since she started using the herbal supplement, ginkgo biloba. What is the most important information for the nurse to include in the teaching plan for this patient?
- A. Nausea and diarrhea can occur when using this supplement.
- B. Ginkgo biloba use should be limited and not taken during pregnancy.
- C. Aspirin and non-steroidal anti-inflammatory drugs interact with ginkgo.
- D. Anxiety and headaches increase with the use of ginkgo biloba.
Correct Answer: C
Rationale: This question is identical to Question 39. Ginkgo biloba’s interaction with aspirin/NSAIDs (C) increases bleeding risk, a critical teaching point. Other side effects (A, D) and pregnancy limits (B) are less urgent. Note: Duplicate question; consider removing.
After administering five doses of filgrastim, the nurse observes that the patient’s white blood cell count has increased from 2,500/mm^3 to 5,000/mm^3. What action should the nurse take?
- A. Inform the patient that the medication has been effective.
- B. Review the patient’s culture and sensitivity reports.
- C. Implement neutropenic precautions.
- D. Assess the patient’s vital signs.
Correct Answer: A
Rationale: Filgrastim stimulates white blood cell production. An increase from 2,500/mm^3 to 5,000/mm^3 (A) indicates effectiveness, and the patient should be informed. Culture reports (B) are unrelated to filgrastim’s action. Neutropenic precautions (C) are unnecessary with improved counts. Vital signs (D) don’t directly assess filgrastim’s efficacy.
A client has been prescribed ciprofloxacin 400 mg intravenously (IV) every 12 hours to be infused over an hour. The IV bag contains ciprofloxacin 400 mg in dextrose 5% in water (D5W) 200 mL. How many mL/hour should the nurse program the infusion pump to deliver? (Enter numerical value only.)
Correct Answer: 200
Rationale: Infusion rate: 200 mL / 1 hr = 200 mL/hr. The pump should be set to deliver 200 mL/hr to administer ciprofloxacin correctly.