Nokea
Howard is a 72-year-old male who occasionally takes diphenhydramine for his seasonal allergies. Monitoring for this patient taking diphenhydramine would include assessing for:
- A. Urinary retention
- B. Cardiac output
- C. Peripheral edema
- D. Skin rash
Correct Answer: A
Rationale: Diphenhydramine , an antihistamine, has anticholinergic effects that can cause urinary retention, especially in older males; other effects are less common.
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A nurse is teaching a client who has a new prescription for Nitroglycerin transdermal patch for Angina Pectoris. Which of the following instructions should the nurse include?
- A. Remove the patch each evening.
- B. Cut each patch in half if angina attacks are under control.
- C. Take off the nitroglycerin patch for 30 min if a headache occurs.
- D. Apply a new patch every 48 hr
Correct Answer: A
Rationale: Removing the patch nightly prevents tolerance to nitroglycerin.
Patients who are on chronic long-term corticosteroid therapy need education regarding:
- A. Receiving all vaccinations, especially the live flu vaccine
- B. Reporting black tarry stools or abdominal pain
- C. Eating a high carbohydrate diet with plenty of fluids
- D. Small amounts of alcohol are generally tolerated
Correct Answer: B
Rationale: Black tarry stools signal GI bleeding from corticosteroids; live vaccines are contraindicated.
Suzanne is started on paroxetine (Paxil), a selective serotonin reuptake inhibitor (SSRI), for depression. Education regarding her antidepressant includes:
- A. SSRIs may take 2 to 6 weeks before she will have maximum drug effects.
- B. Red-green color blindness may occur and should be reported.
- C. If she experiences dry mouth or heart rates greater than 80, she should stop taking the drug immediately.
- D. She should eat lots of food high in fiber to prevent constipation.
Correct Answer: A
Rationale: SSRIs require 2-6 weeks for full effect, a key patient education point.
Patrick is a 10-year-old patient who presents with uncomfortable constipation. Along with diet changes, a laxative is ordered to provide more rapid relief of constipation. An appropriate choice of medication for a 10-year-old child would be:
- A. PEG 3350 (Miralax)
- B. Bisacodyl (Dulcolax) suppository
- C. Docusate (Colace) suppository
- D. Polyethylene glycol electrolyte solution
Correct Answer: A
Rationale: PEG 3350 is safe and effective for kids; suppositories (B, C) are less preferred, and PEG solution is for bowel prep.
A nurse is caring for a group of clients who are not protected against Varicella. The nurse should prepare to administer the Varicella vaccine at this time to which of the following clients?
- A. 24-year-old woman in the third trimester of pregnancy
- B. 12-year-old child who has a severe allergy to neomycin
- C. 2-month-old infant who has no health problems
- D. 32-year-old man who has essential hypertension
Correct Answer: D
Rationale: Varicella vaccine is safe for the 32-year-old ; it's contraindicated in pregnancy, neomycin allergy, and infants under 1 year.