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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.
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The nurse is preparing to administer a scheduled dose of labetalol orally to a client with hypertension. The client’s vital signs are temperature 99° F (37.2 C), heart rate 48 beats/minute, respirations 16 breaths/minute, and blood pressure (BP) 150/90 mm Hg. What action should the nurse take?
- A. Withhold the scheduled dose and notify the healthcare provider.
- B. Administer the dose and monitor the client’s BP regularly.
- C. Assess for orthostatic hypotension before administering the dose.
- D. Apply a telemetry monitor before administering the dose.
Correct Answer: A
Rationale: Labetalol, a beta-blocker, can worsen bradycardia (heart rate 48 bpm). Withholding the dose and notifying the provider (A) is safest. Administering (B) risks exacerbating bradycardia. Orthostatic hypotension assessment (C) and telemetry (D) are secondary.
A female patient who follows a vegetarian diet has recently been prescribed warfarin. She mentions that she consumes leafy green vegetables daily. What should be the nurse’s response?
- A. Praise the patient for her healthy lifestyle and encourage her to maintain her current dietary habits.
- B. Assure the patient that her dietary choices will enhance the effectiveness of the medication in preventing blood clots.
- C. Inform the patient that her healthcare provider needs to be informed about her current diet.
- D. Recommend that the patient substitutes the leafy vegetables with a protein source like nuts or beans.
Correct Answer: C
Rationale: Leafy greens, high in vitamin K, can reduce warfarin’s anticoagulant effect. Informing the provider (C) ensures dose adjustment. Praising (A) or assuring enhanced efficacy (B) ignores the interaction. Substituting vegetables (D) is unnecessary with proper monitoring.
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.
An adult patient at an outpatient clinic has been prescribed the antibiotic tetracycline HCl. What instructions should the nurse include in the patient’s teaching plan?
- A. Consume with milk or antacids to prevent gastrointestinal irritation.
- B. Protect your skin from sunlight while on this medication.
- C. Enhance gastrointestinal absorption by taking with orange juice.
- D. Return to the clinic weekly for serum drug level checks.
Correct Answer: B
Rationale: This question is identical to Question 9. Tetracycline increases photosensitivity, requiring sun protection (B). Milk/antacids (A) and orange juice (C) impair absorption. Weekly drug checks (D) are unnecessary. Note: Duplicate question; consider removing.
A client with benign prostatic hyperplasia has been prescribed tamsulosin. What should the nurse do to monitor for an adverse reaction?
- A. Monitor the client’s blood pressure.
- B. Assess the client’s urine output.
- C. Perform a bladder scan.
- D. Obtain the client’s daily weights.
Correct Answer: A
Rationale: Tamsulosin, an alpha-blocker, can cause hypotension and dizziness (A), requiring blood pressure monitoring. Urine output (B) and bladder scans (C) assess BPH, not adverse effects. Daily weights (D) monitor fluid status, not tamsulosin risks.