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Prior to administering an oral dose of methylprednisolone, the nurse determines the client's serum total calcium level is 5.5 mg/dL (1.375 mmol/L). What action is most important for the nurse to take?
- A. Administer the medication with a glass of milk.
- B. Begin tapering the drug dose per protocol.
- C. Notify the healthcare provider of the finding.
- D. Teach the client about foods high in calcium.
Correct Answer: C
Rationale: A calcium level of 5.5 mg/dL is critically low, requiring immediate provider notification for evaluation. Milk administration, tapering, or dietary teaching are not immediate priorities.
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A client with peptic ulcer disease is scheduled to receive doses of pantoprazole IV and sucralfate PO before breakfast at 0730. The client reports experiencing heartburn when the nurse brings the scheduled medications. Which action should the nurse take?
- A. Hold the dose of IV pantoprazole until the client has finished eating breakfast.
- B. Provide a PRN dose of antacid along with the scheduled medications.
- C. Instruct the client to take the dose of sucralfate PO while eating breakfast.
- D. Administer both of the medications before breakfast as scheduled.
Correct Answer: D
Rationale: Pantoprazole and sucralfate should be administered before breakfast to maximize acid suppression and ulcer protection. Delaying pantoprazole reduces efficacy, antacids interfere with sucralfate absorption, and sucralfate requires an empty stomach.
A client with a history of smoking cigarettes for many years arrives at the clinic and expresses a desire to stop smoking. The client receives a prescription for bupropion to reduce nicotine cravings. Which information should the nurse include in the discharge teaching?
- A. Administer each dose with at least 8 ounces of water.
- B. Consume tyramine-free foods while taking the medicine.
- C. Be aware that difficulty sleeping and weight loss may occur.
- D. Notify the healthcare provider if experiencing changes in taste.
Correct Answer: C
Rationale: Bupropion may cause insomnia and weight loss, which are important side effects for the client to understand. Water intake, tyramine-free diets, and taste changes are not primary concerns with bupropion.
A young adult female client who is planning to become pregnant asks the nurse if she can continue taking isotretinoin for cystic acne. Which information is most important for the nurse to provide this client?
- A. Breastfeeding is not recommended while taking this medication.
- B. Do not take multiple vitamins that contain vitamin A while taking this drug.
- C. Baseline liver function results must be obtained during therapy.
- D. Discontinue this medication one month before attempting to conceive.
Correct Answer: D
Rationale: Isotretinoin is highly teratogenic, requiring discontinuation at least one month before conception to prevent birth defects. Breastfeeding, vitamin A, and liver monitoring are secondary concerns.
The nurse is assessing the client to update the plan of care.Choose the most likely options for the information missing from the statement by selecting from the lists of options provided. "The nurse determines that the client's is experiencing -----------, and the blood pressure changes are the result of-------------------.
- A. Adverse drug reaction
- B. Antibiotic
- C. Syncope
- D. Heart failure
- E. IV infiltration
Correct Answer: A,B
Rationale: The client’s symptoms (dizziness, hives, etc.) indicate an adverse reaction (Red Man Syndrome) to vancomycin, causing hypotension. Both blanks are correctly filled by 'Adverse drug reaction' and 'Antibiotic' (vancomycin).
A client with narcolepsy receives a new prescription for methylphenidate. Prior to administration of the medication, the nurse should review the medical record for which condition?
- A. Hypercholesterolemia.
- B. Bronchitis.
- C. Diabetes mellitus.
- D. Hypertension.
Correct Answer: D
Rationale: Methylphenidate, a stimulant, can exacerbate hypertension, requiring careful review of blood pressure history. Hypercholesterolemia, bronchitis, and diabetes are less critical concerns.