Nokea
A nurse is planning teaching for a client who is trying to quit smoking. Which of the following instructions about nicotine replacement options should the nurse include?
- A. Change the nicotine patch every other day.
- B. Do not drink beverages while sucking on a nicotine lozenge.
- C. Chew nicotine gum for 10 min before spitting it out.
- D. Administer 2 sprays of nicotine nasal spray in each nostril with each dose.
Correct Answer: B
Rationale: The correct answer is B: Do not drink beverages while sucking on a nicotine lozenge. This instruction is important because beverages can interfere with the absorption of nicotine from the lozenge. Nicotine replacement therapy works best when the nicotine is absorbed properly, so avoiding beverages while using the lozenge will help ensure its effectiveness. Changing the nicotine patch every other day (choice A) is incorrect as patches are typically changed daily. Chewing nicotine gum for 10 minutes before spitting it out (choice C) is incorrect as the gum should be chewed until a tingling sensation is felt, then parked between the cheek and gum. Administering 2 sprays of nicotine nasal spray in each nostril with each dose (choice D) is incorrect as the dosage is usually one spray in each nostril.
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A nurse is providing teaching to a client who has a new prescription for theophylline, a sustained-released capsule. Which of the following statements by the client indicates an understanding of the teaching?
- A. I can take my medication in the morning with my coffee.
- B. I may sprinkle the medication in applesauce.
- C. I should limit my fluid intake while on this medication.
- D. I will need to have blood levels drawn.
Correct Answer: D
Rationale: Answer D is correct because monitoring blood levels is crucial for theophylline therapy due to its narrow therapeutic range. Regular monitoring helps ensure the drug is at a safe and effective level in the body. Taking the medication with food or fluids, as indicated in choices A and C, can affect its absorption or metabolism, leading to suboptimal effects or toxicity. Sprinkling the medication in applesauce, as in choice B, can alter the drug's sustained-release mechanism, causing rapid release and possible adverse effects. Therefore, choice D is the best option for ensuring theophylline therapy's safety and efficacy.
A nurse is assessing a client after administering phenytoin IV bolus for a seizure. Which of the following should the nurse identify as an adverse effect of this medication?
- A. Hypoglycemia
- B. Bradycardia
- C. Red man syndrome
- D. Hypotension
Correct Answer: D
Rationale: The correct answer is D: Hypotension. Phenytoin can cause hypotension as an adverse effect due to its vasodilatory properties. The drug can cause a decrease in blood pressure, leading to symptoms such as dizziness and lightheadedness. This adverse effect is important for the nurse to recognize as it can potentially lead to complications such as falls in the client.
A: Hypoglycemia is not a common adverse effect of phenytoin.
B: Bradycardia is not a typical adverse effect of phenytoin.
C: Red man syndrome is associated with vancomycin, not phenytoin.
Summary: Phenytoin is more likely to cause hypotension as an adverse effect, rather than hypoglycemia, bradycardia, or red man syndrome.
A nurse is preparing to administer subcutaneous heparin to a client. Which of the following should the nurse take?
- A. Massage the site after administering the medication
- B. Use a 21-gauge needle for the injection
- C. Aspirate before injecting the medication
- D. Insert the needle at least 5 cm (2 in) from the umbilicus
Correct Answer: D
Rationale: The correct answer is D: Insert the needle at least 5 cm (2 in) from the umbilicus. This is crucial to prevent any potential harm to the abdominal organs located around the umbilicus. Inserting the needle too close could lead to injury or bleeding. Massaging the site after administering (A) is not recommended as it can cause bruising or discomfort. Using a 21-gauge needle (B) is not specified for subcutaneous heparin injections. Aspirating before injecting (C) is not necessary for subcutaneous injections, as the risk of hitting a blood vessel is low.
A nurse is planning care for a client who requires treatment for high cholesterol. Which of the following prescriptions should the nurse expect to administer?
- A. Colchicine
- B. Cimetidine
- C. Colesevelam (Welchol)
- D. Chlorpromazine
Correct Answer: C
Rationale: The correct answer is C: Colesevelam (Welchol). This medication is a bile acid sequestrant commonly used to treat high cholesterol by binding to bile acids in the intestine, preventing their reabsorption, thus lowering LDL cholesterol levels. Colchicine (A) is used to treat gout, Cimetidine (B) for ulcers, and Chlorpromazine (D) for psychotic disorders. These medications are not indicated for high cholesterol.
A nurse is preparing to administer the initial dose of penicillin G IM to a client. The nurse should monitor for which of the following as an indication of an allergic reaction following the injection?
- A. Urticaria
- B. Bradycardia
- C. Pallor
- D. Dyspepsia
Correct Answer: A
Rationale: The correct answer is A: Urticaria. Urticaria, or hives, is a classic sign of an allergic reaction. It presents as raised, red, itchy welts on the skin. This occurs due to histamine release in response to the allergen (penicillin in this case). Monitoring for urticaria is crucial as it indicates a potentially serious allergic reaction that may progress to anaphylaxis. Bradycardia (B), Pallor (C), and Dyspepsia (D) are not typically associated with allergic reactions to penicillin. Bradycardia is a slow heart rate, pallor is paleness of the skin, and dyspepsia is indigestion. These symptoms are more likely related to other conditions or side effects rather than an allergic reaction.