The client with coronary artery disease is prescribed one (1) baby aspirin a day. Which instructions should the nurse provide the client concerning this medication?
- A. Take the medication on an empty stomach.
- B. Do not take Tylenol while taking this drug.
- C. If experiencing joint pain, notify the HCP.
- D. Notify the HCP if stools become dark and tarry.
Correct Answer: D
Rationale: Dark, tarry stools suggest GI bleeding, a serious aspirin side effect, requiring HCP notification. Empty stomach, Tylenol, or joint pain are less critical.
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An adult client has been diagnosed as having rheumatoid arthritis and is started on piroxicam (Feldene) 20 mg daily. Two days later, the client calls the nurse and says that her joints still hurt. What is the best response for the nurse to make?
- A. It may take up to two weeks before results are seen with Feldene.
- B. Take aspirin with the Feldene. It has an additive effect.
- C. Come in to see the physician. You should have pain relief by now.
- D. You may need more medication. Take one additional pill each day.
Correct Answer: A
Rationale: Piroxicam, an NSAID, may take up to two weeks for full anti-inflammatory effects.
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.
The male client with a chronic urinary tract infection is prescribed trimethoprim-sulfamethoxazole (Bactrim). Which statement indicates the client needs more teaching?
- A. I will drink six (6) to eight (8) glasses of water a day.
- B. I am going to have to take this medication forever.
- C. I can stop taking this medication if there is no more burning.
- D. I may get diarrhea with this medication, but I can take Imodium.
Correct Answer: C
Rationale: Stopping Bactrim when symptoms resolve risks incomplete treatment and resistance; full course is needed. Hydration, duration, and diarrhea management are correct.
Which laboratory test should the nurse monitor for the client receiving the intravenous steroid Solu-Medrol?
- A. Potassium level.
- B. Sputum culture and sensitivity.
- C. Glucose level.
- D. Arterial blood gases.
Correct Answer: C
Rationale: Solu-Medrol (methylprednisolone) can cause hyperglycemia, requiring glucose monitoring, especially IV. Potassium, sputum, or ABGs are less directly affected.
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.
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