Nokea
The clinic nurse is reviewing prescriptions with the parents of the school-aged child with newly diagnosed generalized contact dermatitis. Which prescription should the nurse question with the HCP?
- A. Oral prednisone
- B. Calamine lotion
- C. Oral diphenhydramine
- D. Hydrocortisone cream
Correct Answer: A
Rationale: A: Prednisone (Deltasone) would not be a first-line treatment for contact dermatitis, and its use should be questioned. Prednisone may be added later if the contact dermatitis has not resolved. B: Calamine lotion is used to promote drying and help relieve itching. C: Diphenhydramine (Benadryl) helps to relieve itching. D: Hydrocortisone cream is an anti-inflammatory agent used to treat contact dermatitis.
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The nurse teaches the client with relapsing-remitting MS about glatiramer. Which information addressed by the client indicates that the nurse's teaching has been effective? Select all that apply.
- A. Keep the medication vial refrigerated until it is to be used.
- B. Glatiramer is given by injection into the subcutaneous tissue.
- C. Rotate injection sites and wait a week before using a site again.
- D. The thigh and abdomen are the best subcutaneous injection sites.
- E. Syringes are washed, air dried, and reused until the needle is dull.
Correct Answer: A,B,C
Rationale: A: Glatiramer is used to delay the progression of MS. To maximize the therapeutic effects of glatiramer, it should be refrigerated and reconstituted correctly. B: Glatiramer is only administered subcutaneously; accidental IV administration must be avoided. C: Injection sites are rotated to prevent skin breakdown or lumps at the injection sites. D: Appropriate subcutaneous injection sites for glatiramer include the thigh, back of the hip, abdomen, and upper arm. E: Used syringes should be placed in a puncture-resistant container for proper disposal. Syringes and needles should not be reused.
Which of the following injuries, if demonstrated by a client entering the Emergency Department, is the highest priority?
- A. open leg fracture
- B. open head injury
- C. stab wound to the chest
- D. traumatic amputation of a thumb
Correct Answer: C
Rationale: A stab wound to the chest might result in lung collapse and mediastinal shift that, if untreated, could lead to death. Treatment of an obstructed airway or a chest wound is a higher priority than hemorrhage. The principle of ABC (airway, breathing, and circulation) prioritizes care decisions.
The HCP prescribes a second antihypertensive medication for the client who has poorly controlled BP on one medication. If prescribed, which medication combination should the nurse question?
- A. Atenolol and metoprolol
- B. Metolazone and valsartan
- C. Captopril and furosemide
- D. Bumetanide and diltiazem
Correct Answer: A
Rationale: A: The nurse should question this medication combination. When two medications are used to treat hypertension, each should be from different drug classifications. Atenolol (Tenormin) and metoprolol (Lopressor) are both beta-adrenergic blockers and have the same general mechanism of action. B: Metolazone (Zaroxolyn) is a thiazide-like diuretic, and valsartan (Diovan) is an ARB. C: Captopril (Capoten) is an ACE inhibitor, and furosemide (Lasix) is a loop diuretic. D: Bumetanide (Bumex) is a loop diuretic, and diltiazem (Cardizem) is a calcium channel blocker.
The nurse is caring for a client who has recently started using a PCA pump for pain management. Which of the following statements indicates a need for additional education.
- A. I will continue to report my pain score during assessments.
- B. I understand that there is a maximum dose in an hour that I can receive regardless of how many times I press the button.
- C. I think this new PCA pump is going to finally get rid of my back pain.
- D. I have more control of when and how much medication I receive.
Correct Answer: C
Rationale: The nurse should assess the client for reasonable versus unreasonable expectations of pain management when using a PCA pump. The patient should not expect the pain to go away completely.
The nurse telephones the HCP to request a pm anxiolytic medication order for a hospitalized client having occasional anxiety. Which medication, if prescribed, should the nurse question regarding its effectiveness for prn use?
- A. Buspirone
- B. Lorazepam
- C. Clorazepate
- D. Clonazepam
Correct Answer: A
Rationale: Buspirone (BuSpar) has a 10- to 14-day delay in therapeutic onset, making it unsuitable for prn use.