Nokea
The male client is self-medicating with the H-2 antagonist cimetidine (Tagamet). Which complication can occur while taking this medication?
- A. Melena.
- B. Gynecomastia.
- C. Pyrosis.
- D. Eructation.
Correct Answer: B
Rationale: Cimetidine can cause gynecomastia due to antiandrogen effects, especially in males. Melena, pyrosis, or eructation are unrelated.
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The client with type 2 diabetes is diagnosed with gout and prescribed allopurinol (Zyloprim). Which instruction should the nurse discuss when teaching about this medication?
- A. The client will probably develop a red rash on the body.
- B. The client should drink two (2) to three (3) liters of water a day.
- C. The client should take this medication on an empty stomach.
- D. The client will need to increase oral diabetic medications.
Correct Answer: B
Rationale: Allopurinol increases uric acid excretion, risking kidney stones; 2–3 L water daily prevents this. Rash is possible but not probable, stomach timing is flexible, and diabetes meds are unaffected.
The nurse is preparing to administer 37.5 mg of meperidine (Demerol) IM to a client who is having pain. The medication comes in a 50-mg/mL vial. Which action should the nurse implement?
- A. Notify the pharmacist to bring the correct vial.
- B. Have another nurse verify wastage of medication.
- C. Administer one (1) mL of medication to the client.
- D. Request the HCP to increase the client's dose.
Correct Answer: B
Rationale: Dose: 37.5 mg / 50 mg/mL = 0.75 mL. Wasting 0.25 mL requires verification by another nurse, per narcotic protocols.
A post-operative client has a prescription for acetaminophen with codeine. What should the nurse recognize as a primary effect of this combination?
- A. Enhanced pain relief
- B. Minimized side effects
- C. Prevention of drug tolerance
- D. Increased onset of action
Correct Answer: A
Rationale: Enhanced pain relief. Combination of analgesics with different mechanisms of action can afford greater pain relief.
The nurse is administering an intravenous vesicant chemotherapeutic agent to a client. Which assessment would require the nurse's immediate action?
- A. Stomatitis lesion in the mouth
- B. Severe nausea and vomiting
- C. Complaints of pain at site of infusion
- D. A rash on the client's extremities
Correct Answer: C
Rationale: Complaints of pain at site of infusion. A vesicant is a chemotherapeutic agent capable of causing blistering of tissues and possible tissue necrosis if there is extravasation. These agents are irritants which cause pain along the vein wall, with or without inflammation.
The client is complaining of nausea, and the nurse administers the antiemetic promethazine (Phenergan), IVP. Which intervention has priority for this client after administering this medication?
- A. Instruct the client to call the nurse before getting out of bed.
- B. Evaluate the effectiveness of the medication.
- C. Assess the client's abdomen and bowel sounds.
- D. Tell the client not to eat or drink for at least one (1) hour.
Correct Answer: A
Rationale: Promethazine causes sedation and orthostatic hypotension; instructing to call before ambulating prevents falls, the priority post-IVP.