Nokea
The nurse is administering a.m. medications. Which medication should the nurse administer first?
- A. The daily digoxin to the client diagnosed with congestive heart failure.
- B. The loop diuretic to the client with a serum potassium level of 3.1 mEq/L.
- C. The mucosal barrier Carafate to the client diagnosed with peptic ulcer disease.
- D. Solu-Medrol IVP to a client diagnosed with chronic lung disease.
Correct Answer: C
Rationale: Carafate (sucralfate) forms a protective barrier and must be given on an empty stomach, 30–60 minutes before other meds, to be effective for PUD.
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A client with atrial fibrillation is receiving digoxin (Lanoxin). Which of these assessments is most important for the nurse to perform?
- A. Monitor blood pressure every 4 hours
- B. Measure apical pulse prior to administration
- C. Maintain accurate intake and output records
- D. Record an EKG strip after administration
Correct Answer: B
Rationale: Measure apical pulse prior to administration. Digitoxin decreases conduction velocity through the AV node and prolongs the refractory period. If the apical heart rate is less than 60 beats/minute, withhold the drug. The apical pulse should be taken with a stethoscope so that there will be no mistake about what the heart rate actually is.
Which observation, if reported by a client, is most suggestive of an adverse reaction to gentamicin?
- A. A WBC of 8000
- B. Ringing in the ears
- C. Itching
- D. Nasal stuffiness
Correct Answer: B
Rationale: Gentamicin is ototoxic. Ringing in the ears suggests possible damage to the eighth cranial nerve, the auditory nerve. A WBC of 8000 is normal.
The client diagnosed with migraine headaches is prescribed propranolol (Inderal), a beta blocker, for prophylaxis. Which information should the nurse teach the client?
- A. Instruct to take the medication at the first sign of headache.
- B. Teach the client to take his or her radial pulse for one (1) minute.
- C. Explain this drug may make the client thirsty and have a dry mouth.
- D. Discuss the need to increase artificial light in the home.
Correct Answer: B
Rationale: Propranolol can cause bradycardia; teaching pulse monitoring ensures safety. It’s prophylactic, not acute, and dry mouth or lighting are unrelated.
The client is to receive 3,000 mg of medication daily in a divided dose every eight (8) hours. The medication comes 500 mg per tablet. How many tablets will the nurse administer at each dose?
Correct Answer: 2
Rationale: Daily dose: 3,000 mg / 3 doses (every 8 hr) = 1,000 mg/dose. Tablets: 1,000 mg / 500 mg/tablet = 2 tablets per dose.
The male client with a chronic urinary tract infection is prescribed trimethoprim-sulfamethoxazole (Bactrim). Which statement indicates the client needs more teaching?
- A. I will drink six (6) to eight (8) glasses of water a day.
- B. I am going to have to take this medication forever.
- C. I can stop taking this medication if there is no more burning.
- D. I may get diarrhea with this medication, but I can take Imodium.
Correct Answer: C
Rationale: Stopping Bactrim when symptoms resolve risks incomplete treatment and resistance; full course is needed. Hydration, duration, and diarrhea management are correct.