Nokea
The home care nurse notes that an older client is prescribed cimetidine. On assessment of the client, the nurse should check for which side effect of this medication?
- A. Fatigue
- B. Confusion
- C. Constipation
- D. Blurred vision
Correct Answer: B
Rationale: Cimetidine is a gastric acid secretion inhibitor. Older clients are especially susceptible to the central nervous system side effects of cimetidine. The most frequent of these is confusion. Less common central nervous system side effects include headache, dizziness, drowsiness, agitation, and hallucinations. None of the remaining options are associated with the use of this medication.
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The nurse collecting data from the client is providing instructions regarding a new prescription for disulfiram. Which datum is important for the nurse to obtain before beginning the administration of this medication?
- A. When the last full meal was consumed
- B. When the last alcoholic drink was consumed
- C. If the client has a history of hyperthyroidism
- D. If the client has a history of diabetes insipidus
Correct Answer: B
Rationale: Disulfiram may be used as an adjunct treatment for selected clients with chronic alcoholism who want to remain in a state of enforced sobriety. Clients must abstain from alcohol intake for at least 12 hours before the initial dose of the medication is administered. Therefore, it is important for the nurse to determine when the last alcoholic drink was consumed. The medication is used with caution in clients with diabetes mellitus, hypothyroidism, epilepsy, cerebral damage, nephritis, and hepatic disease. It is also contraindicated in severe heart disease, psychosis, or hypersensitivity related to the medication.
The nurse should turn the client on bed rest every 2 hours to prevent the development of pressure ulcers. In addition, the nurse should:
- A. Have the client walk at least twice a day
- B. Insert an indwelling urinary catheter
- C. Monitor serum albumin
- D. Monitor the white blood cell count
Correct Answer: C
Rationale: Monitoring serum albumin assesses nutritional status, which is critical for skin integrity and preventing pressure ulcers. Walking is contraindicated for bed rest, catheters increase infection risk, and white blood cell count is less relevant.
The nurse is caring for a client with a history of chronic obstructive pulmonary disease who is prescribed fluticasone (Flovent). The nurse should instruct the client to:
- A. Use the inhaler as needed for shortness of breath.
- B. Rinse the mouth after using the inhaler.
- C. Shake the inhaler before use.
- D. Take two puffs twice daily.
Correct Answer: B
Rationale: Rinsing the mouth after using fluticasone prevents oral candidiasis, a common side effect of inhaled corticosteroids.
The nurse reviews the client's laboratory report to determine the client's blood level of valproic acid (Depakene), which is 35 mcg/mL. Based on this report, what should the nurse do first?
- A. Withhold the next dose of valproic acid.
- B. Notify the physician.
- C. Give the next dose as ordered.
- D. Take the client's vital signs.
Correct Answer: B
Rationale: A valproic acid level of 35 mcg/mL is below the therapeutic range (50-100 mcg/mL), indicating a need to notify the physician for potential dose adjustment.
Select the legal term that is accurately paired with its description.
- A. Assault: Touching a person without their consent
- B. Battery: Threatening to touch a person without their consent
- C. Slander: False oral defamatory statements.
- D. Slander: False written defamatory statements.
Correct Answer: C
Rationale: Slander is correctly defined as false oral defamatory statements. Assault is threatening harm , battery is unauthorized touching , and libel is false written defamation .