Nokea
The client is being taught how to take alendronate (Fosamax) for osteoporosis treatment. Which statement indicates that the client needs further teaching?
- A. I should take this medication at bedtime
- B. I will need to take this medication for at least 3 years
- C. I should sit up for 30 minutes after taking the medication
- D. I should take this medication with a full glass of water
Correct Answer: A
Rationale: The correct answer is A because taking Fosamax at bedtime is incorrect. It should be taken in the morning with a full glass of water to prevent esophageal irritation. Choice B is correct; alendronate is typically taken for several years to treat osteoporosis. Choice C is correct as remaining upright for 30 minutes after taking Fosamax helps prevent esophageal irritation. Choice D is also correct as taking alendronate with a full glass of water is necessary to ensure proper absorption.
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The healthcare provider prescribes amoxicillin (Amoxil) 1.5 grams PO daily, in equally divided doses to be administered every 8 hours. The medication is available in a bottle labeled Amoxicillin (Amoxil) suspension 200 mg/5 ml. How many ml should the nurse administer every 8 hours?
- A. 10 ml
- B. 12.5 ml
- C. 15 ml
- D. 17.5 ml
Correct Answer: B
Rationale: To calculate the correct dosage, first, determine the total daily dose: 1.5 grams = 1500 mg. Since the medication is 200 mg/5 ml, for 1500 mg, the nurse needs to administer 1500/200 = 7.5 times the 5 ml dose. Therefore, 7.5 x 5 ml = 37.5 ml total daily dose. To administer this every 8 hours, divide 37.5 ml by 3 (8 hours intervals in a day) to get 12.5 ml to be administered every 8 hours. Choice A, C, and D are incorrect as they do not reflect the correct calculation of the dose based on the prescription and the available concentration.
A male client is admitted to the mental health unit because he experiences panic attacks when driving on the freeway. To attempt to desensitize this fear, what action should the nurse encourage the client to implement?
- A. Watch training videos of people driving in various environments
- B. Begin visualizing himself driving each route to the freeway
- C. Take antianxiety medication two hours before driving on freeways
- D. Get in the car with a support person and drive on a freeway during rush hour
Correct Answer: B
Rationale: Visualization techniques, such as visualizing himself driving each route to the freeway, are commonly used in desensitization therapy to help clients gradually overcome their fears. Watching videos of others driving or taking medication do not actively involve the client in facing their fear, which is essential in desensitization therapy. Getting in the car with a support person during rush hour may exacerbate the client's anxiety rather than help in desensitization.
A client who is bleeding after a vaginal delivery receives a prescription for methylergonovine (Methergine) 0.4 mg IM every 2 hours, not to exceed 5 doses. The medication is available in ampules containing 0.2 mg/ml. What is the maximum dosage in mg that the nurse should administer to this client?
- A. Encourage oral fluids as tolerated
- B. Decrease oral intake to 200 ml
- C. Allow the client to have exactly 400 ml oral intake
- D. Limit oral intake to 900 to 1,000 ml
Correct Answer: D
Rationale: The maximum dosage the nurse should administer is 2 mg. This is calculated based on the prescription of 0.4 mg IM every 2 hours, not to exceed 5 doses. Since the medication is available in ampules containing 0.2 mg/ml, the nurse should administer 2 ml (0.2 mg/ml x 10 ml) for each dose, not exceeding 5 doses. Therefore, the nurse should limit the client's oral intake to 900 to 1,000 ml, to avoid exceeding the maximum dosage of 2 mg.
Nurses working in labor and delivery are demanding a change in policy because they believe they are required to float more often than nurses on other units. However, floating to labor and delivery is not reciprocated because other nurses are not competent to provide highly specialized obstetrical skills. What action is best for the nurse-manager to implement?
- A. Require cross-training for obstetrics for other nurses
- B. Propose a method for self-staffing labor and delivery
- C. Remind nurses that floating is an administrative policy
- D. Encourage nurses to share their feelings with administration
Correct Answer: B
Rationale: The best action for the nurse-manager to implement is to propose a method for self-staffing labor and delivery. This approach allows nurses to manage their schedules, ensuring a fair balance of workloads. Requiring cross-training for obstetrics for other nurses (Choice A) may not be feasible or necessary for all units. Reminding nurses that floating is an administrative policy (Choice C) does not address the underlying issue of workload balance. Encouraging nurses to share their feelings with administration (Choice D) may not lead to a concrete solution for the unequal floating concerns.
A client with diabetes mellitus reports feeling dizzy and has a blood glucose level of 50 mg/dl. What action should the nurse take first?
- A. Administer 1 mg of glucagon intramuscularly
- B. Provide 15 grams of carbohydrate
- C. Check the client's blood pressure
- D. Notify the healthcare provider
Correct Answer: B
Rationale: Providing 15 grams of carbohydrate is the initial action to treat hypoglycemia. When a client with diabetes mellitus experiences symptoms of hypoglycemia, such as dizziness and with a blood glucose level of 50 mg/dl, the immediate priority is to raise their blood sugar levels quickly. Administering carbohydrates, such as fruit juice or glucose tablets, is the recommended first step to reverse hypoglycemia. Administering glucagon intramuscularly is usually reserved for severe hypoglycemia when the client is unconscious or unable to swallow. Checking the client's blood pressure is important but not the primary intervention for hypoglycemia. Notifying the healthcare provider can be done after the immediate management of hypoglycemia.