Nokea
Cholestyramine is prescribed, and the nurse provides instructions to the client about the medication. Which client statement indicates a need for further teaching?
- A. I should take this medication with meals.
- B. I need to mix the medication with juice or applesauce.
- C. I should increase my fluid intake while taking this medication.
- D. I should call my primary health care provider immediately if it causes constipation.
Correct Answer: D
Rationale: Common side effects of cholestyramine include constipation, nausea, indigestion, and flatulence. Therefore, it is not necessary to contact the primary health care provider immediately if constipation occurs. Cholestyramine must be administered with food to be effective. This medication should not be taken dry, and it can be mixed in water, juice, carbonated beverages, applesauce, or soup. Increasing fluids will minimize the constipating effects of the medication.
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A client has had same-day surgery to insert a ventilating tube into the tympanic membrane. Which statement assures the nurse that the client understands the discharge instructions?
- A. I will use a shower cap when taking a shower.
- B. I was told to try and avoid taking medications for pain.
- C. I need to wash my hair quickly; taking 2 minutes or less.
- D. Swimming is allowed only if I keep my head above water.
Correct Answer: A
Rationale: After the insertion of tubes into the tympanic membrane, it is important to avoid getting water in the ears. A shower cap or earplug may be used when showering if allowed by the primary health care provider. Swimming, showering without a shower cap or ear plugs, and washing the hair are avoided after surgery until the time frame designated for each is identified by the surgeon. The client should take medication as advised for postoperative discomfort.
The nurse performs an initial assessment on a pregnant client and determines that the client is at risk for toxoplasmosis. The nurse provides education to the client on how to prevent the disease. Which statement by the client indicates that teaching has been effective?
- A. It's alright to eat raw meats.
- B. I should wash hands only before meals.
- C. I should avoid exposure to litter boxes used by my cat.
- D. I should use topical corticosteroid treatments prophylactically.
Correct Answer: C
Rationale: Infected house cats transmit toxoplasmosis through the feces. Handling litter boxes can transmit the disease to the pregnant client. Meats that are undercooked can harbor microorganisms that can cause infection. Hands should be washed frequently throughout the day. The use of topical corticosteroids will not prevent exposure to the disease.
A client is being treated for an atrial dysrhythmia with quinidine gluconate. Which statement by the client indicates to the nurse that the medication instructions about what to do if a dose is missed have been understood?
- A. I should call my primary health care provider.
- B. I should take the next prescribed dose as usual.
- C. I should take the dose as soon as I realize I've missed it.
- D. I take two doses of the medication at the next scheduled time.
Correct Answer: B
Rationale: Quinidine gluconate needs to be taken exactly as prescribed. Because of the action and effects of this medication, the client should be instructed to take the medication if remembered within 2 hours of the missed dose, or omit the dose and then resume the normal schedule. There is no need to call the doctor. It is not safe to take the dose whenever it is remembered or to take an extra dose.
The nurse provides instructions to a client about applying a nitroglycerin patch. What statement indicates that the client is using correct technique?
- A. A second patch will be applied if chest pain occurs.
- B. I will apply the patch to a nonhairy area of the body.
- C. I will remove the patch when bathing and reapply it after the bath.
- D. I will remove the patch after gently rubbing the area to activate the medication.
Correct Answer: B
Rationale: Topical nitroglycerin is applied to a nonhairy part of the body. It is used on a scheduled basis and is not prescribed specifically for the occurrence of chest pain. The ointment is not rubbed into the skin; it is reapplied only as directed.
The home care nurse provides instructions about the management of pruritus to a client diagnosed with jaundice. Which statement made by the client suggests to the nurse that the client needs further teaching?
- A. I need to wear loose cotton clothing.
- B. A tepid water bath should help stop the itching.
- C. Keeping the house warmer is likely to lessen the itching
- D. I need to take the prescribed antihistamines as I'm supposed to.
Correct Answer: C
Rationale: Pruritus is caused by the accumulation of bile salts in the skin and results from obstructed biliary excretion. The client would be instructed to keep the house temperature cool in order to minimize the itching. The client should avoid the use of alkaline soap, and he or she (client) should wear loose, soft, cotton clothing. Antihistamines may relieve the itching, as will tepid water and emollient baths.