Nokea
The nurse is administering an antacid to a client with gastroesophageal reflux disease. Which statement best describes the scientific rationale for administering this medication?
- A. This medication will suppress gastric acid secretion.
- B. This medication will decrease the gastric pH.
- C. This medication will coat the stomach lining.
- D. This medication interferes with prostaglandin production.
Correct Answer: C
Rationale: Antacids neutralize acid and coat the stomach, relieving GERD symptoms. Acid suppression, pH decrease, or prostaglandins are unrelated.
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You are caring for a client with deep vein thrombosis who is on Heparin IV. The latest APTT is 50 seconds. If the laboratory normal range is 16-24 seconds, you would anticipate
- A. maintaining the current heparin dose
- B. increasing the heparin as it does not appear therapeutic
- C. giving protamine sulfate as an antidote
- D. repeating the blood test 1 hour after giving heparin
Correct Answer: A
Rationale: maintaining the current heparin dose. The range for a therapeutic APTT is 1.5-2 times the control. Therefore the client is receiving a therapeutic dose of Heparin.
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.
An adult has angina and is to be discharged on transdermal nitroglycerin. Which statement by the client indicates that the client needs additional teaching?
- A. I am glad that I can continue walking.
- B. I will change the site each day.
- C. I will be able to continue to drink alcoholic beverages.
- D. I will need to get up slowly.
Correct Answer: C
Rationale: Alcohol can enhance nitroglycerin’s hypotensive effects, increasing the risk of dizziness or fainting, requiring avoidance.
The elderly client is in a long-term care facility. If the client does not have a daily bowel movement in the morning, he requests a cathartic, bisacodyl (Dulcolax). Which action is most important for the nurse to take?
- A. Ensure the client gets a cathartic daily.
- B. Discuss the complications of a daily cathartic.
- C. Encourage the client to increase fiber in the diet.
- D. Refuse to administer the medication to the client.
Correct Answer: B
Rationale: Daily cathartics risk dependence and electrolyte imbalance; discussing complications educates and promotes safer alternatives like fiber.
The client has the following arterial blood gases: pH 7.19, Paco2 33, Pao2 95, and HCO3 19. Which medication would the nurse prepare to administer based on the results?
- A. Intravenous sodium bicarbonate.
- B. Oxygen via nasal cannula.
- C. Epinephrine intravenous push.
- D. Magnesium hydroxide orally.
Correct Answer: A
Rationale: Metabolic acidosis (low pH, low HCO3) requires sodium bicarbonate to correct pH. Oxygen, epinephrine, or antacids are inappropriate.