Which of the following statements should the nurse include in the teaching about the new medication?
- A. You should take this medication with dairy products.
- B. This medication may cause constipation.
- C. It is common to experience headache or blurred vision while taking this medication.
- D. You should avoid the sun while taking this medication.
- E. You should use an alternate method of birth control while taking this medication.
Correct Answer: D
Rationale: The correct answer is D: You should avoid the sun while taking this medication. This is important because some medications can increase sensitivity to sunlight, leading to sunburn or skin reactions. Avoiding the sun can prevent these adverse effects.
A: You should not take this medication with dairy products as it may interfere with the absorption of the medication.
B: Constipation is a common side effect of some medications, but it is not specific to this particular medication.
C: Headache or blurred vision may occur with some medications, but it is not specific to this particular medication.
E: Using an alternate method of birth control may be necessary if the medication interferes with hormonal contraceptives, but this information is not provided in the question stem.
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A nurse Is evaluating the laboratory results of four clents. The nurse should report which of the following laboratory results should the nurse report to the provider?
- A. A client who has a prescription for heparin and an aPTT of 90 seconds (30-40 seconds).
- B. A client who has a prescription for heparin and an aPTT of 65 seconds (30-40 seconds).
- C. A client who has a prescription for warfarin and an INR of 3.0 (0.8 to 1.1).
- D. A client who has a prescription for warfarin and an INR of 2.0 (0.8 to 1.1).
Correct Answer: A
Rationale: Correct Answer: A
Rationale: A client with a prescription for heparin and an aPTT of 90 seconds indicates that the client's blood is taking too long to clot, which puts the client at risk for bleeding. The aPTT range for a client on heparin therapy is 30-40 seconds, so a result of 90 seconds is significantly elevated and requires immediate attention to prevent bleeding complications.
Summary of other choices:
B: A client with a prescription for heparin and an aPTT of 65 seconds falls within the normal range of 30-40 seconds, so this result does not require immediate reporting.
C: A client with a prescription for warfarin and an INR of 3.0 is within the therapeutic range (2-3) for warfarin therapy, so this result does not require immediate reporting.
D: A client with a prescription for warfarin and an INR of 2.0 is also
A nurse is assessing a client's IV infusion site and notes that the site is cool and edematous. Which of the following actions should the nurse take?
- A. Slow the IV solution rate
- B. Initiate a new IV distal to the initial site
- C. Maintain the extremity below the level of the heart
- D. Apply a warm, moist compress
Correct Answer: D
Rationale: The correct action is to apply a warm, moist compress (Choice D). This helps improve circulation and reduce edema by promoting vasodilation and enhancing tissue perfusion. Cooling and edematous IV sites indicate impaired circulation, which can lead to complications like phlebitis. Slowing the IV rate (Choice A) may not address the underlying issue. Initiating a new IV distal to the initial site (Choice B) may not improve circulation in the affected area. Maintaining the extremity below heart level (Choice C) can worsen edema.
A nurse is caring for a client in a provider's office. Which of the following statements should the nurse include when teaching the client about the prescribed medication? Select all that apply.
- A. The medication can cause nausea, so take with a meal
- B. You can experience vivid nightmares."
- C. You may notice your urine becomes lighter in color
- D. Consumption of a high protein meal can reduce the effectiveness of the medication
- E. You may initially notice an increase in involuntary movements
- F. This medication can make you light-headed if you stand up too quickly from a seated or lying position
Correct Answer: A, B, E, F
Rationale: Correct Answer: A, B, E, F
Rationale:
A: Taking the medication with a meal can help reduce nausea, enhancing tolerance.
B: Mentioning vivid nightmares prepares the client for a potential side effect.
E: Increase in involuntary movements is a common side effect of certain medications.
F: Informing about potential dizziness upon standing up quickly promotes safety.
These statements address medication effects and side effects, promoting client understanding and safety.
Incorrect Choices:
C: Urine color change may not be relevant to the medication being discussed.
D: High protein meal interaction is not mentioned for this medication.
Incorrect choices lack relevance or do not address potential medication effects, making them not suitable for client education.
A nurse is assessing a client after administering phenytoin IV bolus for a seizure. Which of the following should the nurse identify as an adverse effect of this medication?
- A. Hypoglycemia
- B. Bradycardia
- C. Red man syndrome
- D. Hypotension
Correct Answer: D
Rationale: The correct answer is D: Hypotension. Phenytoin can cause hypotension as an adverse effect due to its vasodilatory properties. The drug can cause a decrease in blood pressure, leading to symptoms such as dizziness and lightheadedness. This adverse effect is important for the nurse to recognize as it can potentially lead to complications such as falls in the client.
A: Hypoglycemia is not a common adverse effect of phenytoin.
B: Bradycardia is not a typical adverse effect of phenytoin.
C: Red man syndrome is associated with vancomycin, not phenytoin.
Summary: Phenytoin is more likely to cause hypotension as an adverse effect, rather than hypoglycemia, bradycardia, or red man syndrome.
A nurse is caring for a client who has a prescription for amoxicillin. Which of the following findings indicates the client is experiencing an allergic reaction?
- A. Nausea
- B. Cardiac dysrhythmia
- C. Laryngeal edema
- D. Insomnia
Correct Answer: C
Rationale: The correct answer is C: Laryngeal edema. Laryngeal edema is a severe allergic reaction symptom that can lead to airway obstruction and respiratory distress. This is a life-threatening condition that requires immediate intervention. Nausea (A) and insomnia (D) are common side effects of amoxicillin but not indicative of an allergic reaction. Cardiac dysrhythmia (B) is not a typical allergic reaction symptom to amoxicillin.