Nokea
A woman who is taking cortisone for an acute exacerbation of rheumatoid arthritis is upset about the fat face she has developed. She says to the nurse, 'I'm going to quit taking that cortisone.' The nurse's response should be based on which understanding?
- A. Cortisone does not cause a fat face.
- B. The symptoms will lessen as her body adjusts to the medication.
- C. The drug should be immediately discontinued when adverse effects occur.
- D. Cortisone should never be abruptly discontinued.
Correct Answer: D
Rationale: Abrupt discontinuation of cortisone can cause adrenal insufficiency; tapering is required to prevent complications.
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The nurse is teaching a group of women in a community clinic about prevention of osteoporosis. Which of the following over-the-counter medications should the nurse recognize as having the most elemental calcium per tablet?
- A. Calcium chloride
- B. Calcium citrate
- C. Calcium gluconate
- D. Calcium carbonate
Correct Answer: D
Rationale: Calcium carbonate. Calcium carbonate contains 400 mg of elemental calcium in 1 gram of calcium carbonate.
The client diagnosed with adult-onset asthma is being discharged. Which medication would the nurse expect the health-care provider to prescribe?
- A. A nonsteroidal anti-inflammatory medication.
- B. An antihistamine medication.
- C. An angiotensin-converting enzyme inhibitor.
- D. A proton pump inhibitor.
Correct Answer: None
Rationale: Asthma typically requires bronchodilators (e.g., albuterol) or steroids, not listed. None of the options are standard asthma treatments.
The HCP ordered an angiotensin-converting enzyme (ACE) inhibitor for the client diagnosed with a myocardial infarction. Which statement best explains the rationale for administering this medication to this client?
- A. It will help prevent the development of congestive heart failure.
- B. This medication will help decrease the client's blood pressure.
- C. ACE inhibitors increase the contractility of the heart muscle.
- D. They will help decrease the development of atherosclerosis.
Correct Answer: A
Rationale: ACE inhibitors reduce afterload and prevent ventricular remodeling, lowering CHF risk post-MI, per ACC/AHA guidelines. BP, contractility, or atherosclerosis are secondary.
When providing discharge teaching to a client with asthma, the nurse will warn against the use of which of the following over-the-counter medications?
- A. Cortisone ointments for skin rashes
- B. Aspirin products for pain relief
- C. Cough medications containing guaifenesin
- D. Histamine blockers for gastric distress
Correct Answer: B
Rationale: Aspirin products for pain relief. Aspirin is known to induce asthma attacks. Aspirin can also cause nasal polyps and rhinitis. Warn individuals with asthma about signs and symptoms resulting from complications due to aspirin ingestion.
The nurse administered an IV broad-spectrum antibiotic scheduled every six (6) hours to the client with a systemic infection at 0800. At 1000, the culture and sensitivity prompted the HCP to change the IV antibiotic. When transcribing the new antibiotic order, when would the initial dose be administered?
- A. Schedule the dose for 1400.
- B. Schedule the dose for the next day.
- C. Check with the HCP to determine when to start.
- D. Administer the dose within one (1) hour of the order.
Correct Answer: D
Rationale: New antibiotic orders for active infections require prompt administration (within 1 hour) to maintain therapeutic levels, per sepsis guidelines.