Nokea
The client is to receive a first dose of oral sulfamethoxazole 1 g every 12 hours for treatment of recurrent UTIs. Which information about the client should prompt the nurse to question the medication order?
- A. History of gastric ulcer
- B. Type 1 diabetes mellitus
- C. Urine positive for Escherichia coli
- D. Near-term pregnancy
Correct Answer: D
Rationale: A: History of gastric ulcer is not a contraindication for the use of sulfamethoxazole. B: Type 1 diabetes does not prevent the use of sulfamethoxazole. C: A positive urine culture would be an indication for using sulfamethoxazole. D: Sulfamethoxazole (Bactrim, Septra), a sulfonamide antibiotic, is a category D medication for near-term pregnancy. This means there is positive evidence of human fetal risk, but the benefits from use in pregnant women may be acceptable despite the risk (e.g., for a life-threatening illness or a serious disease for which safer medications cannot be used or are ineffective).
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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.
A client is taking phenelzine (Nardil), and their spouse would like to bring lunch from home. Which of the following is most appropriate for the client to eat?
- A. a banana
- B. grapefruit
- C. a salami sandwich
- D. avocado slices
Correct Answer: B
Rationale: A client taking an MAO Inhibitor, such as phenelzine (Nardil), should avoid tyramine-rich foods, which includes avocados, bananas, and salami.
The client, admitted to the ED, is prescribed to receive 0.5 mg epinephrine subcutaneously for treatment of a severe asthma attack. The medication for injection is supplied in a vial that contains 5 mg/mL. How many milliliters of epinephrine should the nurse administer?
Correct Answer: 0.1
Rationale: Use a proportion to determine the amount in milliliters; then multiply the extremes (outside values) and the means (inside values) and solve for X. 5 mg: 1 mL :: 0.5 mg: X mL; 5X = 0.5 mL; X = 0.1 mL; the nurse should administer 0.1 mL of epinephrine (Adrenalin).
The nurse is reviewing information for the 6-month-old who is being given ranitidine. Which finding should the nurse identify as an adverse effect of ranitidine?
- A. A heart rate of 110 bpm
- B. Oral temperature of 102.7°F (39.3°C)
- C. Spitting up some formula after each feeding
- D. A hard, pebble-like bowel movement every 2 days
Correct Answer: D
Rationale: A: An HR of 110 bpm is normal for a 6-month-old; the range is 80-170 bpm. B: Fever (temperature of 102.7°F) is not an adverse effect of ranitidine. C: Ranitidine is indicated for GERD; spitting up after feedings should improve. If not, then the medication dose may be too low or the medication itself ineffective. Spitting up is not a side effect. D: The nurse should identify that a hard, pebble-like bowel movement every 2 days demonstrates constipation; constipation is an adverse effect of ranitidine (Zantac).
A nurse working a surgical unit, notices a patient is experiencing SOB, calf pain, and warmth over the posterior calf. All of these may indicate which of the following medical conditions?
- A. Patient may have a DVT.
- B. Patient may be exhibiting signs of dermatitis.
- C. Patient may be in the late phases of CHF.
- D. Patient may be experiencing anxiety after surgery.
Correct Answer: A
Rationale: All of these factors (SOB, calf pain, and warmth) indicate a deep vein thrombosis (DVT), which can be a postoperative complication.