Nokea
Ferrous sulfate elixir is prescribed for a client with iron deficiency anemia. Which instruction should the nurse provide this client about taking the liquid medication?
- A. Use a straw to ingest.
- B. Swallow undiluted.
- C. Mix with an antacid.
- D. Take with a glass of milk.
Correct Answer: A
Rationale: Using a straw prevents tooth staining from ferrous sulfate. Undiluted swallowing risks staining, antacids reduce absorption, and milk inhibits iron absorption due to calcium.
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A client with chronic asthma receives a prescription for montelukast, a leukotriene modifier. Which statement by the client indicates to the nurse that medication teaching was effective?
- A. I should take this medication only when I am having an asthma attack.
- B. I will not need to use my inhalers twice a day when I start this medicine.
- C. This medication will stop an asthma attack immediately.
- D. I will take the tablet every evening to control my asthma.
Correct Answer: D
Rationale: Montelukast is a maintenance medication taken regularly (often in the evening) to control asthma. It is not for acute attacks or to replace inhalers, indicating the client understands its role.
A female client who is starting a new prescription for doxycycline hyclate tells the nurse that she takes birth control pills. Which action should the nurse take?
- A. Instruct the client to take the two medications at least two hours apart.
- B. Advise the client that the birth control pills will be less effective while taking doxycycline hyclate.
- C. Notify the healthcare provider of the contraindication to tetracyclines.
- D. Encourage the client to stop taking birth control pills until she has finished taking all the doxycycline hyclate.
Correct Answer: B
Rationale: Doxycycline can reduce birth control pill effectiveness, requiring additional contraception. Timing separation, contraindication notification, or stopping birth control are incorrect actions.
History and physical
Client is a 66-year-old male with a history of type 2 diabetes mellitus and hypertension. He takes a metoprolol, hydrochlorothiazide, and metformin. He went to his primary healthcare provider reporting that he had been having trouble controlling his blood pressure in the last few days. He has also had a severe headache. Client was a direct admit to the hospital from the primary healthcare provider's office.
Nurses notes
1000
Admitted the client to the medical floor. He informs that he already took his metoprolol,
hydrochlorothiazide, and metformin dose. He says his morning glucose was 111 mg/dL (6.16 mmol/L). Rates his pain as 6 on a 0 to 10 pain scale. Minoxidil and ibuprofen given as prescribed.
1200
Pain rated at 1 on a 0 to 10 pain scale.
Lab results
Blood glucose 218mg/dl
Flowsheet
1000
Vital signs
. Temperature 99° F (37.2° C) orally
. Heart rate 59 beats/minute in atrial fibrillation
• Respiratory rate 20 breaths/minute
. Blood pressure 203/166 mm Hg
Oxygen saturation 97% on room air
Orders
Admit to the medical floor
Heart healthy diet
Vital signs every 2 hours and as needed (PRN)
Give minoxidil 5 mg PO now
Give 400 mg ibuprofen PO PRN for pain
Check blood glucose before meals and at sleep (HS)
Review H and P, nurse's notes, laboratory results, flow sheet, and prescriptions. Click to mark whether the assessment finding represents a therapeutic result of the minoxidil administered, a non-therapeutic side-effect, or an unrelated finding. Each row must have one option selected.
- A. Dizziness while sitting up: Non-therapeutic side effect
- B. Blood glucose 218mg/dl: Unrelated finding
- C. Mouth dryness: Non-therapeutic side effect
- D. Blood pressure 162/111mmHg: Therapeutic result
- E. Heart rate 99: Non-therapeutic side effect
- F. Pain of 1 out of 10: Unrelated finding
- G. Urine output 600ml: Unrelated finding
Correct Answer:
Rationale: A: Dizziness is a minoxidil side effect (hypotension). B: High glucose relates to diabetes. C: Dry mouth is a possible side effect. D: Lowered blood pressure is therapeutic. E: Tachycardia is a side effect. F: Pain reduction relates to ibuprofen. G: Urine output is unrelated.
Before administering a laxative to a bedfast client, it is most important for the nurse to perform which assessment?
- A. Assess the client's strength in moving and turning in the bed.
- B. Observe the skin integrity of the client's rectal and sacral areas.
- C. Evaluate the client's ability to recognize the urge to defecate.
- D. Determine the frequency and consistency of bowel movements.
Correct Answer: D
Rationale: Assessing bowel movement frequency and consistency is critical to determine the need for a laxative and monitor its effectiveness. Strength, skin integrity, and urge recognition are less directly related to laxative administration.
During a home visit, the nurse assesses a client with Alzheimer's disease who recently started a new prescription for rivastigmine. The caregiver reports that the client seems to be thinking more clearly but is not sleeping well at night. Which action should the nurse take?
- A. Advise the caregiver that the purpose of the medication is to promote sleep, so a change in medication may be needed.
- B. Explain to the caregiver that insomnia is a common and temporary side effect when the medication is first started.
- C. Instruct the caregiver to withhold the medication until the dosage can be decreased to ensure the client's safety.
- D. Notify the healthcare provider that the dosage of the medication may need to be increased to manage the client's insomnia.
Correct Answer: B
Rationale: Insomnia is a common, often temporary side effect of rivastigmine. Explaining this reassures the caregiver. Rivastigmine is for cognition, not sleep, and withholding or increasing the dose is inappropriate without provider guidance.