Nokea
The client has a PRN prescription for loperamide hydrochloride (Imodium). The nurse understands that this medication is used for which condition?
- A. Constipation
- B. Abdominal pain
- C. An episode of diarrhea
- D. Hematest-positive nasogastric tube drainage
Correct Answer: C
Rationale: Loperamide hydrochloride (Imodium) is an antidiarrheal medication commonly used to manage episodes of diarrhea. It works by slowing down gut movement and reducing the frequency of bowel movements. Loperamide is not indicated for constipation, abdominal pain, or hematest-positive nasogastric tube drainage. It is specifically useful in acute and chronic diarrhea, such as in cases of inflammatory bowel disease, to help control symptoms and decrease fluid loss.
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A client is receiving sulfisoxazole. Which of the following should be included in the list of instructions?
- A. Restrict fluid intake.
- B. Maintain a high fluid intake.
- C. If the urine turns dark brown, call the healthcare provider (HCP) immediately.
- D. Decrease the dosage when symptoms are improving to prevent an allergic response.
Correct Answer: B
Rationale: When a client is taking sulfisoxazole, it is important to maintain a high fluid intake. Each dose of sulfisoxazole should be taken with a full glass of water, as the medication is more soluble in alkaline urine. Restricting fluid intake is not recommended as it can lead to inadequate hydration. Dark brown urine may be a side effect of some forms of sulfisoxazole but does not necessarily warrant immediate notification of the healthcare provider unless accompanied by other concerning symptoms. Decreasing the dosage when symptoms improve is not advised as it may lead to treatment failure or the development of resistance.
Which laboratory test should the nurse monitor to determine the effectiveness of heparin therapy for a client with deep vein thrombosis?
- A. Platelet count
- B. Prothrombin time (PT)
- C. Activated partial thromboplastin time (aPTT)
- D. Hemoglobin and hematocrit
Correct Answer: C
Rationale: The activated partial thromboplastin time (aPTT) is the specific laboratory test used to monitor the effectiveness of heparin therapy in patients with deep vein thrombosis. It measures the time it takes for blood to clot and is crucial in assessing the therapeutic range of heparin. Platelet count, prothrombin time (PT), and hemoglobin and hematocrit levels are important parameters in assessing coagulation and blood status but do not directly indicate the effectiveness of heparin therapy.
Megestrol acetate (Megace), an antineoplastic medication, is prescribed for a client with metastatic endometrial carcinoma. The nurse reviews the client's history and contacts the registered nurse if which diagnosis is documented in the client's history?
- A. Gout
- B. Asthma
- C. Thrombophlebitis
- D. Myocardial infarction
Correct Answer: C
Rationale: Megestrol acetate can increase the risk of thromboembolic events. Clients with a history of thrombophlebitis should not receive this medication due to the increased risk of thromboembolic events. Therefore, the nurse should contact the registered nurse if thrombophlebitis is documented in the client's history to ensure appropriate medication management.
Insulin glargine (Lantus) is prescribed for a client with diabetes mellitus. The nurse tells the client that it is best to take the insulin:
- A. 1 hour after each meal
- B. Once daily, at the same time each day
- C. 15 minutes before breakfast, lunch, and dinner
- D. Before each meal, based on the blood glucose level
Correct Answer: B
Rationale: Insulin glargine (Lantus) is a long-acting insulin with a duration of action of approximately 24 hours, making it suitable for once-daily dosing at the same time each day. This regimen helps maintain consistent blood glucose levels and simplifies the client's treatment routine. Taking insulin glargine once daily provides basal insulin coverage throughout the day, reducing the risk of hypoglycemia compared to short-acting insulins that are taken before each meal.
A client with diabetes mellitus is prescribed prednisone for an acute exacerbation of asthma. Which of the following should the nurse include in the client's teaching plan?
- A. Increase the dose of insulin while taking prednisone.
- B. Take the prednisone with food.
- C. Monitor blood glucose levels closely.
- D. Do not discontinue prednisone abruptly.
Correct Answer: C
Rationale: The correct answer is to monitor blood glucose levels closely. Prednisone can elevate blood glucose levels, necessitating close monitoring. Adjusting the insulin dose may be necessary, but this should be managed by a healthcare provider. Prednisone should be taken with food to reduce gastrointestinal discomfort and should not be stopped suddenly to prevent adverse effects.