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An adult client with type 2 diabetes is taking metformin (Glucophage) 1,000 mg two times every day. After the nurse provides instructions regarding the interaction of alcohol and metformin, the nurse evaluates that the client understands the instructions when the client says:
- A. If I know I'll be having alcohol, I must not take metformin; I could develop lactic acidosis.'
- B. If my physician approves, I may drink alcohol with my metformin.'
- C. Adverse effects I should watch for are feeling excessively energetic, unusual muscle stiffness, low back pain, and a rapid heartbeat.'
- D. If I feel bloated, I should call my physician.'
Correct Answer: A
Rationale: Alcohol combined with metformin increases the risk of lactic acidosis, a serious complication. The client should avoid alcohol while taking metformin.
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The client has a latex allergy. What should the nurse teach the client to do before having surgery at a free-standing surgery center? Select all that apply.
- A. Determine that there will be a latex-safe environment for surgery.
- B. Report symptoms experienced with the latex allergy (e.g., rhinitis, conjunctivitis, flushing).
- C. Notify the health care providers at the surgery center.
- D. Wear a stainless steel medical alert bracelet into the surgical suite.
- E. Ask to have the surgery at a hospital.
Correct Answer: A,B,C
Rationale: Treatment and diagnostic evaluation must be done in a latex-safe environment. Signs/symptoms may be mild to anaphylaxis. Clients with latex allergy are advised to notify their health care providers and to wear a medical ID; however, all metal and jewelry must be removed prior to surgery as they could conduct an electrical current.
When preparing a teaching plan for an adult client about general anesthesia induction, which explanation would be most appropriate?
- A. œYour premedication will put you to sleep.'
- B. œYou will breathe in an inhalant anesthetic mixed with oxygen through a facial mask and receive intravenous medication to make you sleepy.'
- C. œYou will receive intravenous medication to make you sleepy.'
- D. œYou will breathe in medication through a facial mask to make you sleepy.'
Correct Answer: C
Rationale: For adults, explaining that intravenous medication induces sleep is accurate and simple, avoiding overwhelming details while addressing the primary method of general anesthesia induction.
The nurse is administering a saturated solution of potassium iodide (SSKI). The nurse should:
- A. Pour the solution over ice chips.
- B. Mix the solution with an antacid.
- C. Dilute the solution with water, milk, or fruit juice and have the client drink it with a straw.
- D. Disguise the solution in a pureed fruit or vegetable.
Correct Answer: C
Rationale: SSKI has an unpleasant taste and can stain teeth. Diluting it with water, milk, or juice and using a straw minimizes discomfort and staining.
A client with uric acid stones is prescribed a low-purine diet. Which food is allowed?
- A. Liver.
- B. Chicken.
- C. Apples.
- D. Sardines.
Correct Answer: C
Rationale: Apples are low in purines, suitable for a uric acid stone diet.
A 17-year-old, sexually active female client is seen in the family planning clinic and requests hormonal contraceptives. Before examination, the nurse should explain the importance of regular Papanicolaou (Pap) smears. This recommendation is based on the current screening guidelines of the American Cancer Society for Pap smears, which state that:
- A. Pap smears are recommended every other year.
- B. If four consecutive annual Pap smears are negative, the client should schedule repeat Pap smears every 3 years.
- C. The initial Pap smear should be done at age 12.
Correct Answer: B
Rationale: American Cancer Society guidelines recommend Pap smears every 3 years after four consecutive normal annual smears for women who are sexually active or over 21. Screening does not start at age 12, and every-other-year screening is not standard.