Nokea
An adolescent girl has decided to become a vegetarian. The primary care NP should counsel her about iron intake and considering a vitamin containing:
- A. zinc.
- B. vitamin A.
- C. vitamin C.
- D. potassium.
Correct Answer: A
Rationale: The correct answer is A because vegetarians often lack zinc, critical alongside iron. Choice B is incorrect (vitamin A not primary). Choice C is wrong (vitamin C aids iron, not primary). Choice D is inaccurate (potassium unrelated).
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A client with a diagnosis of heart failure is prescribed spironolactone (Aldactone). Which laboratory value should the nurse monitor closely?
- A. Serum calcium
- B. Serum potassium
- C. Serum sodium
- D. Serum glucose
Correct Answer: B
Rationale: The correct answer is B: Serum potassium. Spironolactone is a potassium-sparing diuretic, which can lead to hyperkalemia. Monitoring serum potassium levels is crucial to prevent potential complications related to high potassium levels, such as cardiac arrhythmias. Therefore, close monitoring of serum potassium is essential for clients taking spironolactone. Choices A, C, and D are incorrect because spironolactone does not directly impact serum calcium, sodium, or glucose levels significantly. While these values may be monitored for other reasons in a client with heart failure, they are not the primary focus of monitoring when spironolactone is prescribed.
The NP chooses to give cephalexin every 8 hours based on knowledge of the drug's:
- A. Propensity to go to the target receptor
- B. Biological half-life
- C. Pharmacodynamics
- D. Safety and side effects
Correct Answer: B
Rationale: Choice B is correct because dosing cephalexin every 8 hours aligns with its biological half-life, the time it takes for half the drug to be eliminated, ensuring steady therapeutic levels. Choice A is incorrect as ‘propensity to target receptor' isn't a standard pharmacokinetic term for dosing decisions. Choice C is wrong because pharmacodynamics (drug effects) informs efficacy, not timing. Choice D is incorrect since safety and side effects influence drug choice, not specifically the 8-hour interval.
A client is admitted with coronary artery disease (CAD) and reports dyspnea at rest. What is the nurse's priority intervention?
- A. Elevate the head of the bed.
- B. Administer oxygen.
- C. Perform continuous ECG monitoring.
- D. Apply a nasal cannula.
Correct Answer: A
Rationale: The nurse's priority intervention for a client with coronary artery disease (CAD) experiencing dyspnea at rest is to elevate the head of the bed. Elevating the head of the bed helps improve lung expansion and reduces the workload on the heart, aiding in respiratory effort and cardiac function. This intervention is crucial in enhancing oxygenation and optimizing cardiac output in individuals with CAD presenting with dyspnea. Administering oxygen (Choice B) is important but elevating the head of the bed takes precedence as it directly addresses the client's respiratory distress. Continuous ECG monitoring (Choice C) and applying a nasal cannula (Choice D) are relevant interventions but not the priority when a client with CAD reports dyspnea at rest.
The client is taking interferon alfa-2a (Roferon-A) and ribavirin (Virazole) combination therapy for hepatitis C and reports overwhelming feelings of depression. Which action should the nurse implement first?
- A. Recommend mental health counseling.
- B. Review the medication actions and interactions.
- C. Assess the client's daily activity level.
- D. Provide information about a support group.
Correct Answer: B
Rationale: The priority action for the nurse is to review the medication actions and interactions. Interferon alfa-2a and ribavirin combination therapy for hepatitis C can lead to neuropsychiatric side effects, including depression. By assessing the medication actions and interactions, the nurse can identify if the depression is a known side effect of the medications, and further intervention or adjustment of the treatment plan may be required to address the client's emotional well-being. Recommending mental health counseling (choice A) may be necessary but should come after ensuring that the depression is not solely caused by medication side effects. Assessing the client's daily activity level (choice C) and providing information about a support group (choice D) are important interventions but addressing the medication's potential contribution to the depression takes precedence.
Patient education for the elderly should include:
- A. Explanation of drug purpose
- B. Instructions for safe administration
- C. Potential side effects
- D. All of the above
Correct Answer: D
Rationale: Choice D is correct because explaining purpose (improves adherence), safe administration (prevents errors), and side effects (enhances safety) are all key for elderly education, per geriatric care. Choice A is incorrect alone as it's one aspect. Choice B is wrong by itself because administration is just part. Choice C is incorrect solo since side effects are only one element.