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The female client diagnosed with herpes simplex 2 is prescribed valacyclovir (Valtrex), an antiviral. Which information should the nurse discuss with the client?
- A. Do not get pregnant while on this medication; it will harm the fetus.
- B. The medication does not prevent the transmission of the disease.
- C. There are no side effects when taking this medication by mouth.
- D. The client should get monthly liver function study tests.
Correct Answer: B
Rationale: Valacyclovir reduces symptoms but does not prevent HSV-2 transmission; education is key. Pregnancy risks, no side effects, or liver tests are inaccurate.
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The elderly client is admitted to the emergency department from a long-term care facility. The client has multiple ecchymotic areas on the body. The client is receiving digoxin, a cardiac glycoside; Lasix, a loop diuretic; Coumadin, an anticoagulant; and Xanax, an antianxiety medication. Which order should the nurse request from the health-care provider?
- A. A STAT serum potassium level.
- B. An order to admit to the hospital for observation.
- C. An order to administer Valium intravenous push.
- D. A STAT international normalized ratio (INR).
Correct Answer: D
Rationale: Ecchymosis with Coumadin suggests bleeding risk; STAT INR assesses anticoagulation status, guiding reversal if needed. Potassium, admission, or Valium are less urgent.
Prior to administering Alteplase (TPA) to a client admitted for a cerebral vascular accident (CVA), it is critical that the nurse assess:
- A. Neuro signs
- B. Mental status
- C. Blood pressure
- D. PT/PTT
Correct Answer: D
Rationale: PT/PTT. TPA is a potent thrombolytic enzyme. Because bleeding is the most common side effect, it is most essential to evaluate clotting studies including PT, PTT, APTT, platelets, and hematocrit before beginning therapy.
The client diagnosed with angina must receive a two (2)-inch nitroglycerin paste (Nitro-Bid) application. Which interventions should the nurse implement? Select all that apply.
- A. Wear gloves when administering.
- B. Remove the old Nitro-Bid paper.
- C. Apply the paper on a hairy spot.
- D. Put medication only on the legs.
- E. Report any headache to the HCP.
Correct Answer: A,B
Rationale: Gloves prevent nurse absorption, and removing old paste ensures accurate dosing. Hairy spots reduce adhesion, leg-only application is incorrect, and headaches are expected.
A client with anemia has a new prescription for ferrous sulfate. In teaching the client about diet and iron supplements, the nurse should emphasize that absorption of iron is enhanced if taken with which substance?
- A. Acetaminophen
- B. Orange juice
- C. Low fat milk
- D. An antacid
Correct Answer: B
Rationale: Orange juice. Ascorbic acid enhances the absorption of iron.
A 2-year-old child who weighs 33 pounds is to receive a total daily dose of 25 mg/kg of a medication. It is to be administered in three evenly divided doses. The label reads 150 mg/mL. How many milliliters will be injected per dose?
- A. 0.5 mL
- B. 0.83 mL
- C. 3.75 mL
- D. 155 mL
Correct Answer: B
Rationale: First, convert 33 pounds to kilograms: 33 ÷ 2.2 = 15 kg. Then, calculate daily dose: 15 × 25 = 375 mg. Divide by 3 doses: 375 ÷ 3 = 125 mg/dose. Finally, calculate volume: 125 ÷ 150 = 0.83 mL.