Nokea
The client is being discharged with a prescription for an inhaled glucocorticoid for asthma. Which of the following statements indicates additional education is needed prior to discharge?
- A. I will hold my breath for 10 seconds after each puff.
- B. I will wait five minutes after taking this medication and then gargle water.
- C. I will wait at least one minute in between each puff.
- D. I will take this medication daily even if I am not having symptoms.
Correct Answer: B
Rationale: The client should gargle and spit water immediately after taking an inhaled glucocorticoid to remove residue of the medication, which can lead to thrush.
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The nurse is preparing to administer medications at 1700 to multiple clients with GI problems. Which medication should be the nurse's priority when the meal trays are due to arrive at 1700?
- A. Misoprostol
- B. Famotidine
- C. Cimetidine
- D. Bisacodyl
Correct Answer: A
Rationale: A: The nurse's priority should be to administer misoprostol (Cytotec), a gastric protectant, first because it should be taken with meals to minimize diarrhea. B: Famcomputers (Pepcid), a histamine receptor agonist, should be taken after meals. C: Cimetidine (Tagamet HB), a histamine receptor agonist, should be taken after meals. D: Bisacodyl (Dulcolax), a laxative, should be taken at least one hour after meals.
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 3-year-old with LTB is receiving aerosolized racemic epinephrine. Which assessment finding should the nurse recognize as indicating that the treatment is having an adverse effect?
- A. Heart rate of 180 beats/min
- B. Blood pressure of 60/40 mm Hg
- C. Respiratory rate of 25 breaths/min
- D. Pulse oximetry of 90% on room air
Correct Answer: A
Rationale: A: Tachycardia is an adverse effect of racemic epinephrine (AsthmaNefrin). B: Hypertension, not hypotension, is an adverse effect of racemic epinephrine; a BP of 60/40 mm Hg in a 3-year-old indicates hypotension. C: A respiratory rate of 25 breaths/min is normal for a 3-year-old. D: A pulse oximetry reading of 90% is concerning and may indicate the need for supplemental oxygen, but it is not an adverse effect from the medication.
The client is placed on lorazepam for short-term treatment of anxiety. Which instruction by the nurse is most important with lorazepam use?
- A. Take a second tablet if your anxiety is not being adequately relieved.
- B. If lorazepam is less effective after a few weeks, notify your provider.
- C. Avoid caffeinated foods and beverages, including tea and chocolate.
- D. If you are experiencing drowsiness or dizziness, notify your provider.
Correct Answer: B
Rationale: Lorazepam (Ativan) is a benzodiazepine anxiolytic and sedative-hypnotic medication. If it is less effective after a few weeks, the client may be developing a tolerance to lorazepam, and the HCP should be notified of this.
What classification of drug is Diltiazem?
- A. Calcium-Channel Blocker
- B. NSAID
- C. ACE Inhibitor
- D. Beta-Blocker
Correct Answer: A
Rationale: Diltiazem is a calcium-channel blocker that is used to treat hypertension.