Nokea
The client diagnosed with multiple sclerosis (MS) is receiving Lioresal (baclofen), a muscle relaxant. Which information should the nurse teach the client/family?
- A. The importance of tapering off medication when discontinuing medication.
- B. Baclofen may cause diarrhea, so the client should take antidiarrheal medication.
- C. The client should not be allowed to drive alone while taking this medication.
- D. The need for follow-up visits to obtain a monthly white blood cell count.
Correct Answer: A
Rationale: Baclofen requires tapering to prevent withdrawal symptoms, like seizures, per FDA warnings. Diarrhea, driving, or WBC counts are not primary concerns.
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A young woman delivered a 7-lb, 8-oz baby boy spontaneously. Ergotrate 0.4 mg q6h for five days is ordered. A half-hour after the nurse administers the first dose, she complains of abdominal cramping. The nurse's best response is based on which understanding?
- A. Cramping indicates a serious adverse reaction.
- B. Cramping can be reduced by abdominal breathing.
- C. The medication is having the desired effect.
- D. The dosage needs to be reduced.
Correct Answer: C
Rationale: Ergotrate causes uterine contractions, leading to cramping, which is the intended effect to prevent postpartum hemorrhage.
The client admitted with pneumonia is taking Imuran, an immunosuppressive agent. Which question should the nurse ask the client regarding this medication?
- A. Do you know this medication has to be tapered off when discontinued?
- B. Have you been exposed to viral hepatitis B or C recently?
- C. Why are you taking this medication, and how long have you taken it?
- D. Do you have a lot of allergies or sensitivities to different medications?
Correct Answer: C
Rationale: Imuran (azathioprine) use and duration clarify indication (e.g., autoimmune) and infection risk, critical with pneumonia. Tapering, hepatitis, or allergies are less immediate.
The nurse is administering a topical ointment to the client's rash on the right leg. Which intervention should the nurse implement first?
- A. Don nonsterile gloves.
- B. Cleanse the client's right leg.
- C. Check the client's armband.
- D. Wash the hands for 15 seconds.
Correct Answer: D
Rationale: Hand washing is the first step to prevent infection, per aseptic technique. Gloves, cleansing, or armband checks follow.
A client who has Hodgkin's disease receives a weekly IV dose of nitrogen mustard. Which nursing order is most appropriate for this client?
- A. Encourage mouth care with an astringent mouthwash and dental floss after every meal
- B. Encourage organ meats and dried beans and peas
- C. Monitor vital signs daily
- D. Encourage fluid intake to 3000 cc
Correct Answer: D
Rationale: Nitrogen mustard causes bone marrow suppression and nausea; high fluid intake helps flush the drug and prevent dehydration.
The client who has had a kidney transplant tells the nurse he has been taking St. John's wort, an herb, for depression. Which action should the nurse take first?
- A. Praise the client for taking the initiative to treat the depression.
- B. Remain nonjudgmental about the client's alternative treatments.
- C. Refer the client to a psychologist for counseling for depression.
- D. Instruct the client to quit taking the medication immediately.
Correct Answer: D
Rationale: St. John’s wort induces CYP3A4, reducing immunosuppressant efficacy (e.g., cyclosporine), risking transplant rejection. Stopping it is the priority.