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A patient with systemic lupus erythematosus (SLE) is prescribed hydroxychloroquine. What is the most important instruction the nurse should give?
- A. Report any vision changes immediately.
- B. Take the medication with milk.
- C. Avoid high-fat foods.
- D. Increase intake of green leafy vegetables.
Correct Answer: A
Rationale: The correct answer is A: Report any vision changes immediately. This is crucial because hydroxychloroquine can cause retinal toxicity, which may lead to irreversible vision loss. Monitoring for vision changes allows for early detection and intervention. Choice B is incorrect as hydroxychloroquine is typically taken with food or milk to reduce gastrointestinal side effects. Choice C is irrelevant as there is no specific dietary restriction for hydroxychloroquine. Choice D is also incorrect as there is no evidence to support increasing green leafy vegetable intake in relation to hydroxychloroquine therapy.
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The healthcare provider is caring for a client who has just undergone a thyroidectomy. Which assessment finding requires immediate intervention?
- A. Hoarse voice.
- B. Difficulty swallowing.
- C. Numbness and tingling around the mouth.
- D. Sore throat.
Correct Answer: C
Rationale: The correct answer is C: Numbness and tingling around the mouth. This finding indicates potential hypocalcemia, a common complication post-thyroidectomy due to inadvertent removal of parathyroid glands. Immediate intervention is necessary to prevent severe hypocalcemia symptoms like tetany and seizures. Hoarse voice (A) and difficulty swallowing (B) are expected post-thyroidectomy due to surgical trauma, while sore throat (D) is common from intubation.
The nurse is administering sevelamer (RenaGel) during lunch to a client with end-stage renal disease (ESRD). The client asks the nurse to bring the medication later. The nurse should describe which action of RenaGel as an explanation for taking it with meals?
- A. Prevents indigestion associated with the ingestion of spicy foods.
- B. Binds with phosphorus in foods and prevents absorption.
- C. Promotes stomach emptying and prevents gastric reflux.
- D. Buffers hydrochloric acid and prevents gastric erosion.
Correct Answer: B
Rationale: The correct answer is B: Binds with phosphorus in foods and prevents absorption. Sevelamer (RenaGel) is a phosphate binder used in ESRD to reduce phosphorus levels. Taking it with meals allows it to bind with phosphorus in food, preventing its absorption in the gastrointestinal tract. This helps in controlling hyperphosphatemia, a common complication in ESRD. Choices A, C, and D are incorrect as RenaGel does not prevent indigestion, promote stomach emptying, or buffer hydrochloric acid.
What instructions should the nurse give to a patient with cervical cancer who is planned to receive external-beam radiation to prevent complications from the effects of the radiation?
- A. Test all stools for the presence of blood.
- B. Maintain a high-residue, high-fiber diet.
- C. Clean the perianal area carefully after every bowel movement.
- D. Inspect the mouth and throat daily for the appearance of thrush.
Correct Answer: C
Rationale: The correct answer is C: Clean the perianal area carefully after every bowel movement. This is important to prevent skin breakdown and infection due to the potential side effect of radiation-induced diarrhea. By maintaining good hygiene in the perianal area, the patient can reduce the risk of complications such as skin irritation and infection.
Choice A is incorrect because testing stools for the presence of blood is not directly related to preventing complications from external-beam radiation.
Choice B is incorrect because while a high-residue, high-fiber diet may be beneficial for some cancer patients, it is not specifically recommended to prevent complications from radiation therapy in this case.
Choice D is incorrect because inspecting the mouth and throat daily for thrush is more relevant for patients receiving chemotherapy or immunosuppressive therapy, not specifically for those undergoing external-beam radiation.
A patient with anemia is prescribed ferrous sulfate. What advice should the nurse give regarding the administration of this medication?
- A. Take with dairy products to increase absorption.
- B. Take on an empty stomach for best absorption.
- C. Avoid vitamin C while taking this medication.
- D. Take before bedtime.
Correct Answer: B
Rationale: The correct answer is B: Take on an empty stomach for best absorption. Ferrous sulfate is best absorbed on an empty stomach to maximize its effectiveness. When taken with food or dairy products (Choice A), the absorption of iron is reduced. Vitamin C actually enhances the absorption of iron, so avoiding it (Choice C) is not recommended. Taking the medication before bedtime (Choice D) may lead to gastrointestinal side effects and is not optimal for absorption.
A patient with deep vein thrombosis (DVT) is prescribed warfarin. Which dietary instruction should the nurse provide?
- A. Avoid foods high in vitamin K.
- B. Increase intake of dairy products.
- C. Limit intake of citrus fruits.
- D. Avoid high-sodium foods.
Correct Answer: A
Rationale: The correct answer is A: Avoid foods high in vitamin K. Warfarin is a vitamin K antagonist, so consuming high-vitamin K foods can counteract its effects. By avoiding such foods, the medication can work effectively in preventing further blood clot formation. Choice B is incorrect because dairy products do not directly interact with warfarin. Choice C is incorrect as citrus fruits do not have a significant impact on warfarin therapy. Choice D is incorrect as sodium intake is not directly related to the action of warfarin.