Nokea
The health care provider has told a client to take over-the-counter supplemental calcium carbonate 1000 mg/day for treatment of osteoporosis. Which instruction should the clinic nurse reinforce with the client?
- A. Monthly calcium levels will need to be drawn
- B. Stop vitamin D supplements when taking calcium
- C. Take calcium at bedtime
- D. Take calcium in divided doses with food
Correct Answer: D
Rationale: Taking calcium carbonate in divided doses with food enhances absorption and reduces GI upset. Monthly calcium levels are unnecessary, vitamin D should continue, and bedtime dosing is less effective.
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The clinic nurse is reinforcing teaching to a client who has been prescribed transdermal scopolamine to prevent motion sickness during an upcoming vacation on a cruise ship. Which of the following statements made by the nurse are appropriate? Select all that apply.
- A. Apply the patch when the ship starts moving and not before.'
- B. Dispose of the patch out of reach of children and pets.'
- C. Ensure that the old patch is removed before applying a new one.'
- D. Place the patch on a hairless, clean, dry area behind the ear.'
- E. Wash your hands with soap and water after handling the patch.'
Correct Answer: B,C,D,E
Rationale: Appropriate scopolamine instructions include safe disposal , removing old patches , correct placement , and hand washing . Applying the patch only when moving is incorrect, as it should be applied hours before travel.
A client asks the nurse to explain the basic ideas of homeopathic medicine. The response that best explains this approach is that such remedies
- A. destroy organisms causing disease
- B. maintain fluid balance
- C. boost the immune system
- D. increase bodily energy
Correct Answer: C
Rationale: boost the immune system. The practitioner treats with minute doses of plant, mineral or animal substances which provide a gentle stimulus to the body's own defenses.
The nurse should monitor for which potential complication in a client receiving IV vancomycin and gentamicin?
- A. Blood in nasogastric tube drainage
- B. Decrease in red blood cell count
- C. Increase in serum creatinine level
- D. Onset of muscle aches and cramping
Correct Answer: C
Rationale: Vancomycin and gentamicin are nephrotoxic, so monitoring for increased serum creatinine is essential to detect kidney injury. GI bleeding , anemia , and muscle cramps are less directly related.
A client is scheduled for a myelogram. Which of the following medications orders should be questioned?
- A. Ampicillin (Pencipen) $250 \mathrm{mg} \mathrm{PO} \mathrm{q} 6$ hours
- B. Motrin (Ibuprofen) $400 \mathrm{mg} \mathrm{PO} \mathrm{q} 4$ hours PRN for headache
- C. Secobarbital (Seconal) $50 \mathrm{mg}$ HS PRN for sleep
- D. Propoxyphene (Darvon) $65 \mathrm{mg} \mathrm{PO} \mathrm{q} 4$ hours for pain
Correct Answer: B
Rationale: Ibuprofen (Motrin) has anticoagulant properties, increasing bleeding risk during a myelogram, a procedure involving spinal puncture. Other medications are safer.
The nurse manager hears a provider loudly criticize one of the staff nurses within the hearing range of others. The nurse manager's next action should be to
- A. Walk up to the provider and quietly state: 'Stop this unacceptable behavior.'
- B. Allow the staff nurse to handle this situation without interference
- C. Notify the chief of the other administrative persons of a breech of professional conduct
- D. Request an immediate private meeting with the provider and staff nurse
Correct Answer: D
Rationale: Assertive communication respects the needs of all parties to express themselves, but not at the expense of others. The nurse manager needs to protect clients and staff from this display and assist the nurse employee.