Nokea
Phil is starting treatment with febuxostat (Uloric). Education of patients starting febuxostat includes:
- A. Gout may worsen with therapy
- B. Febuxostat may cause severe diarrhea
- C. He should consume a high-calcium diet
- D. He will need frequent CBC monitoring
Correct Answer: A
Rationale: Febuxostat can initially worsen gout as uric acid mobilizes; diarrhea or calcium aren't emphasized.
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A nurse in a provider's office is monitoring serum electrolytes for four older adult clients who take digoxin. Which of the following electrolyte values increases a client's risk for Digoxin toxicity?
- A. Calcium 9.2 mg/dL
- B. Calcium 10.3 mg/dL
- C. Potassium 3.4 mEq/L
- D. Potassium 4.8 mEq/
Correct Answer: C
Rationale: Hypokalemia (3.4 mEq/L, C) increases digoxin toxicity risk by enhancing its effects.
When melatonin is used to induce sleep, the recommendation is that the patient:
- A. Take 10 mg 30 minutes before bed nightly
- B. Take 1 to 5 mg 30 minutes before bed nightly
- C. Not take melatonin more than three nights a week
- D. Combine melatonin with zolpidem (Ambien) for the greatest impact on sleep
Correct Answer: B
Rationale: 1-5 mg of melatonin 30 minutes before bed is the recommended dose for sleep induction.
A nurse is caring for a client who has a new prescription for Lithium Carbonate. When teaching the client about ways to prevent Lithium toxicity, the nurse should advise the client to do which of the following?
- A. Avoid the use of acetaminophen for headaches.
- B. Restrict intake of foods rich in sodium.
- C. Decrease fluid intake to less than 1,500 mL daily
- D. Limit aerobic activity in hot weather
Correct Answer: D
Rationale: Limiting activity in hot weather prevents dehydration, which increases lithium levels and risk of toxicity.
Despite good blood pressure control, an NP might change a patient's drug from an angiotensin-converting enzyme (ACE) inhibitor to an angiotensin II receptor blocker (ARB) because the ARB:
- A. Is stronger than the ACE inhibitor
- B. Does not produce a dry, hacky cough
- C. Has no effect on the renal system
- D. Reduces sodium and water retention
Correct Answer: B
Rationale: ARBs lack the cough side effect common with ACE inhibitors.
The American Dietetic Association has recommended the use of specific nutritional supplements in the following population(s):
- A. 400 IU per day of vitamin D in all infants and children
- B. 1,000 IU per day of vitamin D for all pregnant women
- C. 60 mg per day of iron for all adults over age 50 years
- D. All of the above
Correct Answer: A
Rationale: The ADA recommends 400 IU/day of vitamin D for infants and children to support bone health.