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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.
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A nurse is caring for a client diagnosed with stage 4 cancer who has a prescription for a subcutaneous morphine sulfate patch for pain. The client is short of breath and difficult to arouse. During a head-to-toe assessment, the nurse finds four patches on the client’s body. What should be the nurse’s first action?
- A. Administer a narcotic reversal drug.
- B. Apply an oxygen face mask.
- C. Remove the morphine patches.
- D. Monitor the client’s blood pressure.
Correct Answer: C
Rationale: Four morphine patches suggest overdose, causing respiratory depression and sedation. Removing the patches (C) stops further absorption. Naloxone (A) or oxygen (B) may follow, but removal is first. Blood pressure monitoring (D) is secondary.
The nurse is preparing a discharge teaching plan for a patient who is taking ciprofloxacin hydrochloride tablets due to suspected anthrax exposure. What instructions should be included in the teaching plan?
- A. Crush and mix the tablets with pudding if you have trouble swallowing the tablets.
- B. Increase fluid intake while taking the medication.
- C. Use nonsteroidal anti-inflammatory drugs (NSAIDs) to relieve mild joint aches and pains caused by the medication.
- D. Report any tendon pain or swelling to the healthcare provider immediately.
- E. Limit exposure to sunlight and avoid tanning beds.
Correct Answer: B,D,E
Rationale: Ciprofloxacin requires high fluid intake (B) to prevent crystalluria, immediate reporting of tendon pain/swelling (D) due to rupture risk, and sun protection (E) due to photosensitivity. Crushing tablets (A) alters release, risking side effects. NSAIDs (C) increase seizure risk with ciprofloxacin.
A client with a history of chronic obstructive pulmonary disease (COPD) has been prescribed a new ipratropium inhaler. Which action indicates to the nurse that additional teaching is needed?
- A. The client primes the inhaler with 7 pumps.
- B. The client stores the medication at room temperature.
- C. The client rinses their mouth after each use.
- D. The client attaches a spacer device to the inhaler.
Correct Answer: A
Rationale: Ipratropium inhalers require 2-3 priming sprays for new devices, not 7 (A), indicating a need for teaching. Room temperature storage (B), mouth rinsing (C), and spacer use (D) are correct.
A patient who received a renal transplant three months ago is readmitted to the acute care unit with signs of graft rejection. During the patient’s history taking, the nurse finds out that the patient has been self-administering St. John’s Wort, an herbal preparation, on a friend’s advice. What information is most significant about this finding?
- A. St. John’s Wort can decrease plasma concentrations of cyclosporine.
- B. Consumption of St. John’s Wort can reduce the patient’s sodium intake.
- C. Adding the herb can decrease the need for corticosteroids.
- D. The patient probably used this herb to treat depression.
Correct Answer: A
Rationale: St. John’s Wort induces CYP3A4, reducing cyclosporine levels (A), risking transplant rejection. It doesn’t affect sodium (B) or reduce corticosteroid needs (C). Depression treatment (D) is secondary to the transplant risk.
A client with atrial fibrillation has been prescribed dabigatran. What instruction should the nurse include in this client’s teaching plan?
- A. Eliminate spinach and other green vegetables from the diet.
- B. Avoid the use of nonsteroidal anti-inflammatory drugs (NSAIDs).
- C. Continue to obtain scheduled laboratory bleeding tests.
- D. Keep an antidote available in case of hemorrhage.
Correct Answer: B
Rationale: Dabigatran increases bleeding risk; avoiding NSAIDs (B) reduces this risk. Spinach (A) affects warfarin, not dabigatran. Routine bleeding tests (C) aren’t required for dabigatran. Antidotes (D) like idarucizumab are hospital-administered, not kept at home.