Nokea
As the nurse begins to administer scheduled doses of furosemide and nifedipine, the client asks for a PRN dose of aluminum hydroxide. Which action by the nurse would be best ensure the effectiveness of all the medications?
- A. Assess the client's immediate need for the antacid.
- B. Administer all three medications at the same time.
- C. Administer the nifedipine and aluminum hydroxide, then the furosemide 1 hour later.
- D. Administer the furosemide and aluminum hydroxide, then the nifedipine 1 hour later.
Correct Answer: A
Rationale: Antacids such as aluminum hydroxide often interfere with the absorption of other medications. For this reason, antacids should be separated from other medications by at least 1 hour. Because of the diuretic action of the furosemide and the antihypertensive action of the nifedipine, it is important to administer them on time if the client can tolerate waiting for the aluminum hydroxide. The nurse should assess the client to determine the need for the antacid.
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The nurse is caring for a client who is receiving tacrolimus daily. Which finding indicates to the nurse that the client is experiencing an adverse effect of the medication?
- A. Hypotension
- B. Photophobia
- C. Profuse sweating
- D. Decrease in urine output
Correct Answer: D
Rationale: Tacrolimus is an immunosuppressant medication used in the prophylaxis of organ rejection in clients receiving allogenic liver transplants. Adverse reactions and toxic effects include nephrotoxicity and pleural effusion. Nephrotoxicity is characterized by an increasing serum creatinine level and a decrease in urine output. Frequent side effects include headache, tremor, insomnia, paresthesia, diarrhea, nausea, constipation, vomiting, abdominal pain, and hypertension. None of the other options are associated with an adverse reaction to this medication.
The nurse is preparing a client diagnosed with Graves' disease to receive radioactive iodine therapy. What information should the nurse share with the client about the therapy?
- A. After the initial dose, subsequent treatments must continue lifelong.
- B. The radioactive iodine is designed to destroy the entire thyroid gland with just one dose.
- C. It takes 6 to 8 weeks after treatment to experience relief from the symptoms of the disease.
- D. High radioactivity levels prohibit contact with family for 4 weeks after the initial treatment.
Correct Answer: C
Rationale: Graves' disease is also known as toxic diffuse goiter and is characterized by a hyperthyroid state resulting from hypersecretion of thyroid hormones. After treatment with radioactive iodine therapy, a decrease in the thyroid hormone level should be noted, which helps alleviate symptoms. Relief of symptoms does not occur until 6 to 8 weeks after initial treatment. Occasionally, a client may require a second or third dose, but treatments are not lifelong. This form of therapy is not designed to destroy the entire gland; rather, some of the cells that synthesize thyroid hormone will be destroyed by the local radiation. The nurse must reassure the client and family that unless the dosage is extremely high, clients are not required to observe radiation precautions. The rationale for this is that the radioactivity quickly dissipates.
The nurse is caring for a client diagnosed with pneumonia. When considering the client's safety, when will the nurse plan to take the client for a short walk?
- A. After the client eats lunch
- B. After the client has a brief nap
- C. After the client uses the metered-dose inhaler
- D. After assessing the client's oxygen saturation
Correct Answer: C
Rationale: The nurse should schedule activities for the client with pneumonia after the client has received respiratory treatments or medications. After the administration of bronchodilators (often administered by metered-dose inhaler), the client has the best oxygen exchange possible and would tolerate the activity best. Still, the nurse implements activity cautiously, so as not to increase the client's dyspnea. The client would become fatigued after eating; therefore, this is not a good time to ambulate the client. Although the client may be rested somewhat after a nap, the respiratory status of the client may not be at its best. Although monitoring oxygen saturation is appropriate, the intervention itself does not affect the client's respiratory function.
A client has a prescription to receive an enema before bowel surgery. The nurse assists the client into which position to administer the enema?
- A. enema_1.PNG
- B. enema_2.PNG
- C. enema_3.PNG
- D. enema_4.PNG
Correct Answer: C
Rationale: When administering an enema, the nurse places the client in a Sims' position (option 3) exposing the rectal area and allowing the enema solution to flow by gravity in the natural direction of the colon. In the prone position (option 1), the client is lying on the stomach. In the supine position (option 2), the client is lying on the back. The dorsal recumbent position (option 4) is used for abdominal assessment because it promotes relaxation of abdominal muscles.
The nurse is caring for a client diagnosed with preeclampsia. When the client's condition progresses from preeclampsia to eclampsia, what should the nurse's first action be?
- A. Maintain an open airway.
- B. Administer oxygen by face mask.
- C. Assess the maternal blood pressure and fetal heart tones.
- D. Administer an intravenous infusion of magnesium sulfate.
Correct Answer: A
Rationale: Eclampsia is characterized by the occurrence of seizures. If the client experiences seizures, it is important as a first action to establish and maintain an open airway and prevent injuries to the client. Options 2, 3, and 4 are all interventions that should be done but not initially.