Nokea
The nurse is caring for a client receiving pantoprazole. The nurse understands that long-term use of proton pump inhibitors increases the risk of which serious side effects? Select all that apply.
- A. nausea
- B. depression
- C. constipation
- D. rhabdomyolysis
- E. long bone fractures
Correct Answer: D,E
Rationale: Long-term PPI use increases the risk of rhabdomyolysis and long bone fractures due to nutrient malabsorption and muscle damage. Nausea, depression, and constipation are less associated.
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A client with chronic obstructive pulmonary disease (COPD) is admitted to the respiratory unit. Which physician prescription should the nurse question?
- A. Oâ‚‚ at 5 L/min by nasal cannula
- B. Solu Medrol 125 mg IV push every 6 hours
- C. Ceftriaxone (Rocephin) 1gram IVPB daily
- D. Darvocet N 100 po prn pain
Correct Answer: A
Rationale: High-flow oxygen (5 L/min) can suppress the hypoxic drive in COPD clients, risking CO2 retention. Low-flow oxygen (1-2 L/min) is safer and should be questioned.
The physician has ordered Pentam (pentamidine) IV for a client with pneumocystis carinii. While receiving the medication, the nurse should carefully monitor the client's:
- A. Blood pressure
- B. Temperature
- C. Heart rate
- D. Respirations
Correct Answer: A
Rationale: Pentamidine can cause hypotension, so blood pressure monitoring is critical during administration.
The physician has prescribed Coumadin (sodium warfarin) for a client having transient ischemic attacks. Which laboratory test measures the therapeutic level of Coumadin?
- A. Prothrombin time
- B. Clot retraction time
- C. Partial thromboplastin time
- D. Bleeding time
Correct Answer: A
Rationale: Prothrombin time (PT/INR) measures the therapeutic level of warfarin, ensuring effective anticoagulation.
Which assessment finding would the nurse expect in a client with long-term venous insufficiency with the presence of a venous ulcer?
- A. decreased or absent pedal pulses with cool or cold foot
- B. the presence of stasis ulcers over the medial malleolus
- C. skin atrophy and pallor with elevation of the affected leg
- D. decreased circumference in the affected leg due to venous constriction
Correct Answer: B
Rationale: Venous insufficiency causes stasis ulcers, typically over the medial malleolus, due to venous pooling and tissue breakdown.
The nurse is caring for a client receiving peritoneal dialysis. Which of the following assessment findings would require an intervention by the nurse?
- A. Abdominal discomfort during infusion of dialysate.
- B. Presence of constipation.
- C. Cloudy dialysate output.
- D. Ecchymosis around peritoneal catheter.
Correct Answer: C
Rationale: indicates peritonitis, also will see nausea and vomiting, anorexia, abdominal pain, tenderness, rigidity