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The nurse is caring for a patient who is being treated for peptic ulcer disease. Which medication should the patient be taught to avoid?
- A. NSAIDs
- B. Antacids
- C. H2 blockers
- D. PPIs .
- G. A
Correct Answer: NSAIDs can worsen ulcers by irritating the stomach lining. Antacids, H2 blockers, and PPIs aid ulcer healing.
Rationale: The correct answer is A: NSAIDs. NSAIDs, such as ibuprofen and aspirin, can worsen peptic ulcers by irritating the stomach lining and inhibiting prostaglandin synthesis, which is needed for stomach lining protection. Antacids, H2 blockers, and PPIs, on the other hand, help in ulcer healing by reducing stomach acid production or neutralizing acid. Therefore, teaching the patient to avoid NSAIDs is crucial to prevent exacerbation of peptic ulcers.
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Complete the following statement: “Drugs used for the treatment of depression and a range of anxiety disorders including panic, social phobia, and post-traumatic stress disorder are known as…â€
- A. Barbiturates
- B. Rebound insomnia
- C. Antidepressants
- D. Anxiolytics
- G. C
Correct Answer: Barbiturates are sedatives. Rebound insomnia isn't a drug. Antidepressants treat depression and anxiety disorders. Anxiolytics focus on anxiety.
Rationale: The correct answer is C: Antidepressants. Antidepressants are drugs specifically designed to treat depression and various anxiety disorders, including panic, social phobia, and post-traumatic stress disorder. They work by balancing neurotransmitters in the brain to improve mood and reduce symptoms of anxiety. Barbiturates (A) are sedatives, not typically used for treating anxiety or depression. Rebound insomnia (B) is a phenomenon where insomnia worsens after discontinuing sleep medications, not a class of drugs. Anxiolytics (D) are drugs that specifically target anxiety symptoms, but they do not usually address depression. Therefore, the correct choice is C as it accurately describes the drugs used for treating depression and a range of anxiety disorders.
When beginning herbal products, the nurse understands that the best way to identify allergic or other adverse reactions is to have the client:
- A. Take less than the recommended dose initially.
- B. Never take with prescription medications.
- C. Check with a reputable pharmacist.
- D. Use only one herbal preparation at a time.
- G. D
Correct Answer: Lower doses may not reveal reactions. Avoiding prescriptions isn't always necessary. Pharmacist consultation is good but not best for identification. One product at a time isolates reactions.
Rationale: The correct answer is D: Use only one herbal preparation at a time. By using only one herbal preparation at a time, the nurse can accurately identify any allergic or adverse reactions that may occur. This approach allows for clear isolation of the effects of each herb, making it easier to pinpoint the source of any reactions. Taking lower doses (choice A) may not always reveal reactions as some individuals may still have adverse effects. Never taking herbal products with prescription medications (choice B) is overly restrictive and not always necessary. Checking with a reputable pharmacist (choice C) is a good practice for general information but may not be the most effective way to identify specific reactions.
Four patients are due to receive their morning insulin and breakfast will be served in 15 minutes. Which patient should the nurse administer insulin to first?
- A. The patient with a pre-meal glucose level of 90 mg/dL, scheduled to receive 10 units of NPH.
- B. The patient with a pre-meal glucose level of 70 mg/dL, scheduled to receive 2 units of aspart (Novolog) insulin.
- C. The patient with a pre-meal glucose level of 120 mg/dL, scheduled to receive 15 units of NPH.
- D. The patient with a pre-meal glucose level of 170 mg/dL, scheduled to receive 5 units of lispro (Humalog) insulin.
- G. D
Correct Answer: 90 mg/dL (NPH) and 70 mg/dL (aspart) are normal/low, less urgent. 120 mg/dL (NPH) is mildly high. 170 mg/dL with rapid-acting lispro needs priority due to significant elevation.
Rationale: The correct answer is D: The patient with a pre-meal glucose level of 170 mg/dL, scheduled to receive 5 units of lispro (Humalog) insulin. This choice is correct because a glucose level of 170 mg/dL is significantly elevated, indicating a need for immediate insulin administration to prevent further hyperglycemia. Lispro is a rapid-acting insulin, which should be administered promptly before breakfast to control the high blood sugar effectively. Choices A, B, and C have glucose levels within normal or slightly elevated ranges, making them less urgent for immediate insulin administration. Choice D is the most critical due to the high glucose level and the type of insulin being rapid-acting, requiring prompt action to manage the patient's blood sugar levels effectively.
A nurse is reinforcing teaching with a client who was newly prescribed paroxetine (Paxil) (an SSRI) for treatment of panic disorder. Sort the following information by what the nurse should include vs what not to include.
- A. Take this medication just before bedtime to promote sleep.
- B. Herbal medication can be combined with this medication.
- C. Monitor for weight changes while taking this medication.
- D. It can take several weeks before you feel like the medication is helping.
- G. A,C
Correct Answer: Bedtime dosing helps with side effects like drowsiness. Herbal combinations risk serotonin syndrome and should be avoided. Weight changes are a side effect to monitor. It takes weeks for full effect, but this was mislabeled; A and C are correct inclusions.
Rationale: The correct answer is G: A,C. The rationale for this is as follows:
1. A: Taking the medication just before bedtime can help minimize side effects like drowsiness, which is common with SSRIs like paroxetine.
2. C: Monitoring for weight changes is important because weight gain or loss can be a side effect of paroxetine.
3. B: Combining herbal medications with paroxetine can increase the risk of serotonin syndrome, a potentially life-threatening condition.
4. D: It is true that it can take several weeks before feeling the full benefits of paroxetine, but this information was not provided in the question stem.
In summary, A and C are the correct inclusions because they provide important information related to the medication's side effects and administration, while B and D are incorrect because they introduce potential risks and irrelevant information.
A nurse is assisting with the care of four clients who have peptic ulcer disease. The nurse should identify that misoprostol (Cytotec) is contraindicated for which of the following clients?
- A. A client who is pregnant.
- B. A client who has osteoarthritis.
- C. A client who has a urinary tract infection.
- D. A client who has a kidney stone.
- G. A
Correct Answer: Misoprostol can induce labor or miscarriage, making it contraindicated in pregnancy. It's safe for osteoarthritis, UTIs, and kidney stones as it doesn't interact adversely with these conditions.
Rationale: Correct Answer: A. A client who is pregnant.
Rationale: Misoprostol is contraindicated in pregnancy as it can induce labor or miscarriage due to its uterotonic effects. This medication is used to prevent gastric ulcers in patients taking NSAIDs, not for conditions like osteoarthritis, urinary tract infection, or kidney stones. Thus, it is important to avoid its use in pregnant individuals to prevent harm to the fetus.
Summary of Other Choices:
B: Misoprostol is safe for a client with osteoarthritis as it does not pose any specific risks or contraindications for this condition.
C: Misoprostol does not interact adversely with urinary tract infections, so it is safe for a client with this condition.
D: Misoprostol does not have any contraindications for kidney stones; therefore, it is safe for a client with this condition.