Melissa Smith came to the Emergency Department in the last week before her estimated date of confinement complaining of headaches, blurred vision, and vomiting. Suspecting PIH, the nurse should best respond to Melissa's complaints with which of the following statements?
- A. The physician will probably want to admit you for observation.'
- B. The physician will probably order bed rest at home.'
- C. These are really dangerous signs.'
- D. The physician will probably prescribe some medicine for you.'
Correct Answer: B
Rationale: Pregnancy-induced hypertension (PIH) symptoms like headaches, blurred vision, and vomiting suggest preeclampsia, which is best managed with bed rest at home unless severe, requiring hospitalization.
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The nurse is providing teaching to the client receiving a thiazide diuretic. Which points should the nurse plan to include? Select all that apply.
- A. Take the radial pulse before setting up the medication.
- B. Include fruits such as melons and bananas in the diet.
- C. Report side effects such as muscle cramps, nausea, or a skin rash.
- D. Take the last dose at bedtime when fluids are at the highest level.
- E. Avoid high-fat foods; thiazide diuretics increase cholesterol levels.
Correct Answer: B,C,E
Rationale: A: It is unnecessary for the client to monitor the pulse prior to taking thiazide diuretics. B: Thiazide diuretics can cause hypokalemia, and potassium-rich foods can help maintain potassium levels. C: Muscle cramps are a sign of possible medication side effects of hypokalemia and hypocalcemia. Nausea and rash are also medication side effects. D: A diuretic taken at bedtime can cause nocturia and loss of sleep. The usual timing of the last daily dose of a diuretic is at suppertime. E: Thiazide diuretics can increase serum cholesterol, LDL, and triglyceride levels, so teaching the client to avoid high-fat foods will help maintain cholesterol levels.
The client calls a clinic to renew the prescription for insulin being administered subcutaneously via an insulin pump. Which insulin type, if prescribed by the HCP, should the nurse question?
- A. Insulin lispro
- B. Insulin aspart
- C. Insulin glulisine
- D. Insulin glargine
Correct Answer: D
Rationale: A: Lispro (Humalog) is a rapid-acting human insulin analog that can be delivered via an insulin pump. B: Aspart (NovoLog) is a rapid-acting human insulin analog that can be delivered via an insulin pump. C: Glulisine (Apidra) is a rapid-acting human insulin analog that can be delivered via an insulin pump. D: The nurse should question if glargine (Lantus) is prescribed. Glargine is long-duration insulin not suited for delivery by an infusion pump.
The hospitalized client is prescribed to receive ferrous fumarate 200 mg oral daily. When transcribing the medication onto the client's MAR, at which time in military time should the nurse schedule the daily dose for best absorption?
- A. 830
- B. 1000
- C. 1230
- D. 1730
Correct Answer: B
Rationale: A: 0830 is near the time of breakfast in a health care facility. Food reduces the absorption of iron. B: For best absorption and therapeutic effectiveness, the nurse should schedule ferrous fumarate (Feosol) at 1000. Iron preparations should be administered one hour before or two hours after a meal because food diminishes iron absorption. C: 1230 is near lunchtime in a health care facility. Food reduces the absorption of iron. D: 1730 is near the evening meal in a health care facility. Food reduces the absorption of iron.
The clinic nurse is reviewing prescriptions with the parents of the school-aged child with newly diagnosed generalized contact dermatitis. Which prescription should the nurse question with the HCP?
- A. Oral prednisone
- B. Calamine lotion
- C. Oral diphenhydramine
- D. Hydrocortisone cream
Correct Answer: A
Rationale: A: Prednisone (Deltasone) would not be a first-line treatment for contact dermatitis, and its use should be questioned. Prednisone may be added later if the contact dermatitis has not resolved. B: Calamine lotion is used to promote drying and help relieve itching. C: Diphenhydramine (Benadryl) helps to relieve itching. D: Hydrocortisone cream is an anti-inflammatory agent used to treat contact dermatitis.
The client is prescribed varenicline for smoking cessation. The nurse concludes that varenicline is being prescribed primarily for its antagonistic effect. Which statement describes this effect?
- A. Gets readily absorbed into the bloodstream for rapid effectiveness
- B. Demonstrates a high degree of attractiveness for a specific receptor
- C. Blocks receptors in the brain that produce the pleasurable effects of smoking
- D. Stimulates receptors stimulated by smoking, producing similar pleasurable effects.
Correct Answer: C
Rationale: Varenicline (Chantix) functions as an antagonist, blocking receptors to reduce the pleasurable effects of smoking.