Nokea
The LPN is preparing a client for discharge and the discharge medications include phenobarbital. Which of these client statements would indicate a need for reinforced teaching about this medication?
- A. I will need to avoid eating excessive leafy greens.
- B. It's best to take this medication with food.
- C. I can't wait to get back to my nightly glass of wine.
- D. I should try to take this medication at the same time every day.
Correct Answer: C
Rationale: Phenobarbital should not be taken with alcohol as it is a barbiturate. Alcohol may increase the sedative effect.
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The client is prescribed varenicline for smoking cessation. The nurse concludes that varenicline is being prescribed primarily for its antagonistic effect. Which statement describes this effect?
- A. Gets readily absorbed into the bloodstream for rapid effectiveness
- B. Demonstrates a high degree of attractiveness for a specific receptor
- C. Blocks receptors in the brain that produce the pleasurable effects of smoking
- D. Stimulates receptors stimulated by smoking, producing similar pleasurable effects.
Correct Answer: C
Rationale: Varenicline (Chantix) functions as an antagonist, blocking receptors to reduce the pleasurable effects of smoking.
Which of the following is not a nursing responsibility when preparing the client for central line insertion?
- A. advancing the guidewire
- B. explaining the procedure to the client
- C. maintaining sterile technique
- D. ensuring necessary consents are signed
Correct Answer: A
Rationale: The nursing responsibilities include explaining the procedure to the client, ensuring necessary consents are signed according to the facility policy, and maintaining sterile technique when preparing the equipment and supplies. The guidewire will be advanced by the practitioner inserting the central line.
Around what age do children start to develop "stranger anxiety"?
- A. 9 months
- B. 6 months
- C. 3 months
- D. 12 months
Correct Answer: B
Rationale: By 6 months, children should be able to recognize familiar faces, and thus they are aware of strangers. Strangers may illicit anxiety.
The client with CRF is receiving epoetin alfa. Which finding should indicate to the nurse that the action of the medication has been effective?
- A. Urine output increased to 30 mL per hour
- B. Hemoglobin 12 g/dL and hematocrit 36%
- C. BP 110/70 mm Hg and heart rate 68 bpm
- D. Reports an increased energy level and less fatigue
Correct Answer: B
Rationale: A: Epoetin alfa does not have an effect on urine output or BP. B: Epoetin alfa stimulates erythropoiesis, or the production of RBCs. It is used in treating anemias associated with decreased RBC production, such as in renal failure. Hgb and Hct are used to evaluate the medication's effectiveness. The target Hgb for the client with CRF is 12 g/dL. C: Epoetin alfa does not have an effect on BP or HR. D: The client may report increased energy and less fatigue because of the increased Hgb levels, but these findings are not used to evaluate the medication's action.
The client taking imipramine is preparing for a summer vacation. Which information should the nurse include when planning client education regarding imipramine? Select all that apply.
- A. Drink additional fluids and add extra fiber to the diet
- B. Stop imipramine if experiencing any unpleasant side effects.
- C. Avoid alcohol, which can cause an additive depressant effect.
- D. Request an “as needed†sleeping pill in the event of insomnia.
- E. Wear sunglasses, protective clothing, and sunscreen while outdoors.
Correct Answer: A,C,E
Rationale: TCAs such as imipramine (Tofranil) may cause constipation, CNS depression when combined with alcohol, and photosensitivity. Increasing fluids and fiber, avoiding alcohol, and using sun protection are appropriate.