Nokea
The healthcare provider has prescribed silver sulfadiazine (Silvadene) for the client with a partial-thickness burn, which has cultured positive for gram-negative bacteria. The nurse is reinforcing information to the client about the medication. Which statement made by the client indicates a lack of understanding about the treatment?
- A. The medication is an antibacterial.
- B. The medication will help heal the burn.
- C. The medication will permanently stain my skin.
- D. The medication should be applied directly to the wound.
Correct Answer: C
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.
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Prednisone is prescribed for a client with diabetes mellitus who is taking Humulin neutral protamine Hagedorn (NPH) insulin daily. Which of the following prescription changes does the nurse anticipate during therapy with prednisone?
- A. An additional dose of prednisone daily
- B. A decreased amount of daily Humulin NPH insulin
- C. An increased amount of daily Humulin NPH insulin
- D. The addition of an oral hypoglycemic medication daily
Correct Answer: C
Rationale: When prednisone is prescribed for a client with diabetes mellitus who is taking Humulin NPH insulin daily, the nurse should anticipate an increased amount of daily Humulin NPH insulin. Prednisone, a glucocorticoid, can elevate blood glucose levels, requiring an increase in insulin dosage to maintain optimal blood sugar control.
A client is prescribed amlodipine (Norvasc) for hypertension. Which side effect should the nurse instruct the client to report to the healthcare provider?
- A. Dizziness
- B. Constipation
- C. Peripheral edema
- D. Dry cough
Correct Answer: C
Rationale: The correct answer is C, 'Peripheral edema.' Amlodipine (Norvasc) can cause peripheral edema, which is an accumulation of fluid in the extremities and should be reported to the healthcare provider. Dizziness and constipation are possible side effects of amlodipine but are generally less concerning. Dry cough is more commonly associated with ACE inhibitors, not calcium channel blockers like amlodipine.
A client is receiving morphine sulfate subcutaneously for pain. Because morphine sulfate has been prescribed for this client, which nursing action would be included in the plan of care?
- A. Encourage fluid intake.
- B. Monitor the client's temperature.
- C. Maintain the client in a supine position.
- D. Encourage the client to cough and deep breathe.
Correct Answer: D
Rationale: Morphine sulfate suppresses the cough reflex, which can lead to the retention of secretions in the lungs. Encouraging the client to cough and deep breathe helps prevent pneumonia by clearing the airways of any accumulated secretions. This intervention is crucial in clients receiving morphine sulfate to maintain optimal respiratory function.
Tamoxifen is prescribed for the client with metastatic breast carcinoma. The nurse understands that the primary action of this medication is to:
- A. Increase DNA and RNA synthesis.
- B. Promote the biosynthesis of nucleic acids.
- C. Increase estrogen concentration and estrogen response.
- D. Compete with estradiol for binding to estrogen in tissues containing high concentrations of receptors.
Correct Answer: D
Rationale: The primary action of tamoxifen, an antineoplastic medication used in metastatic breast carcinoma, is to compete with estradiol for binding to estrogen receptors in tissues with high receptor concentrations. By doing so, tamoxifen reduces DNA synthesis and estrogen response, leading to its therapeutic effect in inhibiting the growth of estrogen-sensitive breast cancer cells.
The client has been taking omeprazole (Prilosec) for 4 weeks. The ambulatory care nurse evaluates that the client is receiving the optimal intended effect of the medication if the client reports the absence of which symptom?
- A. Diarrhea
- B. Heartburn
- C. Flatulence
- D. Constipation
Correct Answer: B
Rationale: Omeprazole, a proton pump inhibitor, is used as an antiulcer agent to reduce gastric acid secretion. The optimal intended effect of omeprazole is the relief of pain and discomfort associated with gastric irritation, commonly referred to as heartburn. Therefore, the absence of heartburn indicates that the medication is working effectively in managing the client's gastric condition.