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The 30-year-old has been taking olanzapine for the past 5 years for the treatment of schizophrenia. The client, who has a positive family history of DM, is now overweight but is not showing signs of hyperglycemia. When the client asks about the next steps for treatment, how should the nurse respond?
- A. You'll be started on an oral hyperglycemic agent.
- B. I will be teaching you how to self-administer insulin.
- C. You'll need to have a fasting blood glucose level drawn.
- D. Olanzapine will be discontinued and another drug started.
Correct Answer: C
Rationale: Due to the risk of hyperglycemia with olanzapine (Zyprexa), blood glucose testing is needed to determine if medication therapy is indicated.
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The nurse teaches the client who has lesions that have not healed and are recurring about the newly prescribed medication ganciclovir. The nurse should document that teaching about ganciclovir was completed for the client with which illustrated condition?
- A. ganeiclovir_1.PNG
- B. ganeiclovir_2.PNG
- C. ganeiclovir_3.PNG
- D. ganeiclovir_4.PNG
Correct Answer: D
Rationale: A: Client A has vitiligo, a skin disorder characterized by the patchy loss of skin pigment. Vitiligo is treated with topical steroids. B: Client B has dried herpes simplex, usually treated with the antiviral medication acyclovir. C: Client C has keloids (hypertrophic scarring), which usually are not treated with medication. D: Ganciclovir (Cytovene) is an antiviral medication used in the treatment of recurrent genital herpes.
A client with stress incontinence should be advised:
- A. to purchase absorbent undergarments.
- B. that Kegel exercises might help.
- C. that effective surgical treatments are nonexistent.
- D. that behavioral therapy is ineffective.
Correct Answer: B
Rationale: Kegel exercises, tightening and releasing the pelvic floor muscles, might improve stress incontinence. Choice A is not an appropriate treatment for stress incontinence. Several effective surgical treatments exist. Lifestyle and dietary modifications can also be helpful.
The nurse is assessing the client. Which findings indicate that the client may be experiencing physical changes from long-term use of prednisone? Select all that apply.
- A. Weight gain
- B. Increased muscle mass
- C. Fragile skin
- D. Acne vulgaris
- E. Alopecia
Correct Answer: A,C,D
Rationale: A: Weight gain and muscle atrophy are body changes that may occur with long-term glucocorticoid therapy. B: Muscle wasting (not increased muscle mass) is a side effect of prednisone. C: Fragile skin is a possible body change that may occur with long-term glucocorticoid therapy. D: Acne vulgaris may occur with long-term glucocorticoid therapy. E: Hirsutism (not alopecia) is a side effect of prednisone.
The client has been successful at controlling gastroesophageal reflux symptoms without prescription medications. Which OTC medication should the nurse explore whether the client is taking for symptom control?
- A. Aspirin once a day
- B. Famotidine
- C. Ibuprofen
- D. Desloratadine
Correct Answer: B
Rationale: A: Aspirin increases gastric acid secretion and may worsen symptoms. B: The nurse should explore whether the client is taking famotidine (Pepcid) for symptom control. Famotidine blocks histamine-2 receptors on parietal cells, thus decreasing gastric acid production. C: NSAIDs, such as ibuprofen (Motrin), do not reduce gastric acid. D: Desloratadine (Clarinex) blocks only histamine-1 receptors and is not effective against histamine-2 receptors.
One day postoperative, the client complains of dyspnea, and his respiratory rate (RR) is 35, slightly labored, and there are no breath sounds in the lower-right base. The nurse should suspect:
- A. Cor pulmonale
- B. Atelectasis
- C. Pulmonary embolus
- D. Cardiac tamponade
Correct Answer: B
Rationale: No breath sounds in the lower-right base postoperative suggest atelectasis, a lung collapse common after surgery, causing dyspnea and tachypnea.