Nokea
Ciprofloxacin is prescribed for the client to treat a UTI. Which information should the nurse stress when teaching the client about the medication?
- A. Avoid taking ciprofloxacin with dairy products such as milk or yogurt.
- B. Treat diarrhea, a side effect of ciprofloxacin, with bismuth subsalicylate.
- C. Avoid fennel because it will increase the absorption of the ciprofloxacin.
- D. Take dietary calcium tablets one hour before or two hours after ciprofloxacin.
Correct Answer: A
Rationale: A: Ciprofloxacin (Cipro) is a fluoroquinolone antibiotic. Milk or yogurt decreases its absorption and should be avoided. B: Bismuth subsalicylate decreases the absorption of ciprofloxacin and should be avoided. C: Fennel will decrease, not increase, the absorption of the ciprofloxacin. D: Dietary calcium can be taken at any time; it is unaffected by ciprofloxacin.
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The client with GERD is taking cimetidine. Which serum laboratory finding should the nurse determine is most concerning?
- A. Increased liver enzymes
- B. Increased platelet count
- C. Decreased creatinine
- D. Decreased prolactin
Correct Answer: A
Rationale: A: Elevation of liver enzymes should be most concerning because drug-induced hepatitis is an adverse effect of cimetidine (Tagamet HB) therapy. B: Histamine-2 receptor blockers can cause myelosuppression including thrombocytopenia. A decreased (not increased) platelet count would be concerning. C: Renal adverse effects of the drug include elevated (not decreased) creatinine and BUN. D: Cimetidine can increase (not decrease) secretion of prolactin from the anterior pituitary, inducing gynecomastia.
The HCP prescribes haloperidol 4 mg tid oral liquid for the client diagnosed with schizophrenia. How many milliliters should the nurse administer from a bottle labeled “haloperidol 2 mg/mL†for each dose?
Correct Answer: 2
Rationale: Calculation: 4 mg/ 2 mg/mL = 2 mL per dose.
The client with CRF is receiving epoetin alfa. Which finding should indicate to the nurse that the action of the medication has been effective?
- A. Urine output increased to 30 mL per hour
- B. Hemoglobin 12 g/dL and hematocrit 36%
- C. BP 110/70 mm Hg and heart rate 68 bpm
- D. Reports an increased energy level and less fatigue
Correct Answer: B
Rationale: A: Epoetin alfa does not have an effect on urine output or BP. B: Epoetin alfa stimulates erythropoiesis, or the production of RBCs. It is used in treating anemias associated with decreased RBC production, such as in renal failure. Hgb and Hct are used to evaluate the medication's effectiveness. The target Hgb for the client with CRF is 12 g/dL. C: Epoetin alfa does not have an effect on BP or HR. D: The client may report increased energy and less fatigue because of the increased Hgb levels, but these findings are not used to evaluate the medication's action.
The nurse has completed swaddling the 2-month-old infant, prepared supplies to cannulate the scalp vein for an IV infusion, and cleansed and shaved the hair at the site over the temporal bone. Place the remaining steps in the order that they should be performed by the nurse.
- A. Return in 60 minutes and reswaddle the infant in a mummy restraint.
- B. With an assistant holding the infant's head, insert a scalp vein needle and observe for blood return.
- C. Apply lidocaine/prilocaine cream to the site selected and unswaddle the infant after the cream application.
- D. Cleanse the shaved area with an antiseptic solution.
- E. Remove the mummy restraint after initiating the infusion and comfort the infant.
- F. Initiate the infusion and cover the infusion needle with a gauze dressing.
Correct Answer: C,A,D,B,F,E
Rationale: C: Apply lidocaine/prilocaine (EMLA) cream to the site selected and unswaddle the infant after the cream application. An anesthetic cream will numb the site and help reduce the infant's pain during insertion. The infant does not need to remain swaddled while the cream reaches its therapeutic effectiveness in about an hour. A: Return in 60 minutes and reswaddle the infant in a mummy restraint. It takes about an hour for the lidocaine/prilocaine cream to reach its therapeutic effectiveness. The infant should be reswaddled to minimize movement during insertion. D: Cleanse the shaved area with an antiseptic solution. Cleansing the area with an antiseptic solution will help prevent inadvertent introduction of microorganisms into the vascular system. B: With an assistant holding the infant's head, insert a scalp vein needle and observe for blood return. Movement of the infant's head can result in loss of the vein access or a needle-stick injury to the infant or nurse. F: Initiate the infusion and cover the infusion needle with a gauze dressing. Once the vein has been successfully cannulated, the site can be dressed and IV fluids started. E: Remove the mummy restraint after initiating the infusion and comfort the infant. The mummy restraint is no longer needed after the IV catheter has been successfully inserted into a scalp vein.
The client has been receiving clonidine 0.1 mg via transdermal patch once every 7 days. The NA removes the patch with morning cares. Eight hours later, the nurse discovers that the clonidine patch is no longer present. Which assessment finding should be most concerning to the nurse?
- A. Skin tear is noted on the client's upper chest.
- B. Client reports having an excruciating headache.
- C. Blood pressure is noted to be 182/100 mm Hg.
- D. The ECG monitor shows a heart rate of 120 bpm.
Correct Answer: C
Rationale: A: Although a skin tear is concerning and may have occurred during removal, it is not the most concerning. B: Headache can occur from the abrupt removal of clonidine but is not the most concerning. C: Clonidine (Catapres) is an antihypertensive medication. Rebound hypertension occurs from abrupt withdrawal. Immediate intervention is required to lower the BP. D: Tachycardia is an adverse effect of clonidine.