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An adult client has been diagnosed as having rheumatoid arthritis and is started on piroxicam (Feldene) 20 mg daily. Two days later, the client calls the nurse and says that her joints still hurt. What is the best response for the nurse to make?
- A. It may take up to two weeks before results are seen with Feldene.
- B. Take aspirin with the Feldene. It has an additive effect.
- C. Come in to see the physician. You should have pain relief by now.
- D. You may need more medication. Take one additional pill each day.
Correct Answer: A
Rationale: Piroxicam, an NSAID, may take up to two weeks for full anti-inflammatory effects.
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The client received Narcan, a narcotic antagonist, following a colonoscopy. Which action by the nurse has the highest priority?
- A. Document the occurrence in the nurse's notes.
- B. Prepare to administer narcotic medication IV.
- C. Administer oxygen via nasal cannula.
- D. Assess the client every 15 to 30 minutes.
Correct Answer: D
Rationale: Narcan reverses opioids but has a short half-life; frequent assessment (15–30 min) monitors for re-sedation or respiratory depression, the priority.
The nurse is instructing a client with moderate persistent asthma on the proper method for using MDIs (multi-dose inhalers). Which medication should be administered first?
- A. Steroid
- B. Anticholinergic
- C. Mast cell stabilizer
- D. Beta agonist
Correct Answer: D
Rationale: Beta agonist. The beta-agonist drugs help to relieve bronchospasm by relaxing the smooth muscle of the airway. These drugs should be taken first so that other medications can reach the lungs.
An adult is hospitalized for an acute attack of gout. Which medication should the nurse expect to administer?
- A. Morphine
- B. Colchicine
- C. Allopurinol
- D. Acetaminophen
Correct Answer: B
Rationale: Colchicine is used to treat acute gout attacks by reducing inflammation, unlike allopurinol, which prevents attacks.
The client is to receive 3,000 mg of medication daily in a divided dose every eight (8) hours. The medication comes 500 mg per tablet. How many tablets will the nurse administer at each dose?
Correct Answer: 2
Rationale: Daily dose: 3,000 mg / 3 doses (every 8 hr) = 1,000 mg/dose. Tablets: 1,000 mg / 500 mg/tablet = 2 tablets per dose.
Which observation, if reported by a client, is most suggestive of an adverse reaction to gentamicin?
- A. A WBC of 8000
- B. Ringing in the ears
- C. Itching
- D. Nasal stuffiness
Correct Answer: B
Rationale: Gentamicin is ototoxic. Ringing in the ears suggests possible damage to the eighth cranial nerve, the auditory nerve. A WBC of 8000 is normal.