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The client is receiving atropine, an anticholinergic, to minimize the side effects of routine medications. Which intervention will help the client tolerate this medication?
- A. Teach the client about orthostatic hypotension.
- B. Instruct the client to eat a low-residue diet.
- C. Encourage the client to chew sugarless gum.
- D. Discuss the importance of daily isometric exercises.
Correct Answer: C
Rationale: Atropine causes dry mouth; sugarless gum stimulates saliva, improving tolerance. Hypotension, diet, or exercises are unrelated.
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A client with atrial fibrillation is receiving digoxin (Lanoxin). Which of these assessments is most important for the nurse to perform?
- A. Monitor blood pressure every 4 hours
- B. Measure apical pulse prior to administration
- C. Maintain accurate intake and output records
- D. Record an EKG strip after administration
Correct Answer: B
Rationale: Measure apical pulse prior to administration. Digitoxin decreases conduction velocity through the AV node and prolongs the refractory period. If the apical heart rate is less than 60 beats/minute, withhold the drug. The apical pulse should be taken with a stethoscope so that there will be no mistake about what the heart rate actually is.
The nurse is administering a.m. medications. Which medication should the nurse administer first?
- A. The daily digoxin to the client diagnosed with congestive heart failure.
- B. The loop diuretic to the client with a serum potassium level of 3.1 mEq/L.
- C. The mucosal barrier Carafate to the client diagnosed with peptic ulcer disease.
- D. Solu-Medrol IVP to a client diagnosed with chronic lung disease.
Correct Answer: C
Rationale: Carafate (sucralfate) forms a protective barrier and must be given on an empty stomach, 30–60 minutes before other meds, to be effective for PUD.
An adult is hospitalized for an acute attack of gout. Which medication should the nurse expect to administer?
- A. Morphine
- B. Colchicine
- C. Allopurinol
- D. Acetaminophen
Correct Answer: B
Rationale: Colchicine is used to treat acute gout attacks by reducing inflammation, unlike allopurinol, which prevents attacks.
A child and the family about the medication phenytoin (Dilantin) prescribed for seizure control. Which of the following side effects is most likely to occur?
- A. Vertigo
- B. Drowsiness
- C. Gingival hyperplasia
- D. Vomiting
Correct Answer: C
Rationale: Swollen and tender gums occur often with use of phenytoin. Good oral hygiene and regular visits to the dentist should be emphasized.
The client in the intensive care department is receiving 2 mcg/kg/min of dopamine, an inotropic vasopressor. Which intervention should the nurse include in the plan of care?
- A. Monitor the client's blood pressure every two (2) hours.
- B. Assess the client's peripheral pulses every shift.
- C. Use a urometer to assess hourly output.
- D. Ensure the IV tubing is not exposed to the light.
Correct Answer: C
Rationale: Dopamine affects renal perfusion; hourly urine output via urometer monitors efficacy and prevents toxicity. BP, pulses, or light exposure are less critical.