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The nurse is developing the teaching plan for the client who is started on amitriptyline. Which information is most appropriate to include?
- A. Discuss a calorie-controlled diet plan suitable to the client's preferences.
- B. Inform about possible sexual dysfunction and be ready to provide support.
- C. Instruct to stop amitriptyline immediately if having a sudden elevation in BP.
- D. Advise to take amitriptyline upon waking up to manage the side effect of insomnia.
Correct Answer: A
Rationale: Weight gain is often a major concern for clients taking TCAs such as amitriptyline (Elavil). A calorie-controlled diet plan will assist in avoiding weight gain.
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The client with ulcerative colitis is started on sulfasalazine. The nurse overhears the client talking with family members about sulfasalazine and recognizes the need for more teaching when the client makes which statement?
- A. I'll be taking sulfasalazine to help control my diarrhea.
- B. Sulfasalazine will decrease the inflammation in my colon.
- C. After a year of taking sulfasalazine, I'll be cured of the disease.
- D. Sulfasalazine will help to prevent exacerbations of my disease.
Correct Answer: C
Rationale: A: Sulfasalazine reduces inflammation and thereby will reduce the number of diarrheal stools. B: Sulfasalazine, commonly used to treat ulcerative colitis, decreases inflammation in the colon. C: This statement indicates the client needs additional teaching. Ulcerative colitis is a chronic illness. Sulfasalazine (Azulfidine) does not cure ulcerative colitis; the only cure is a total proctocolectomy. D: Sulfasalazine reduces inflammation and thereby will reduce the incidence of flare-ups from ulcerative colitis.
The nurse observes a colleague about to administer an IM injection to the 12-month-old. Which intervention requires the nurse to intervene?
- A. Prepares to give no more than 2 mL of fluid
- B. Plans to give the injection using a 1-inch needle
- C. Plans to give the injection in the dorsal gluteal site
- D. Plans to give the injection after applying lidocaine/prilocaine cream
Correct Answer: C
Rationale: A: No more than 2 mL of fluid should be injected into a muscle. B: The appropriate needle length for an IM injection for children ages 2 to 12 months is 1 inch and 1% inch for toddlers. C: Use of the dorsal gluteal site is not recommended due to a high risk of nerve damage. D: Use of lidocaine/prilocaine cream (EMLA) to numb the area is suggested when time allows but is not required.
The 14-year-old who has GERD is receiving lansoprazole. Which response should the nurse expect if lansoprazole is achieving the desired therapeutic effect?
- A. Increased appetite
- B. Increased GI motility
- C. Decreased epigastric pain
- D. Decreased rectal flatulence
Correct Answer: C
Rationale: A: Lansoprazole would not be expected to change appetite. B: Lansoprazole is not a gastric motility agent. C: Lansoprazole (Prevacid) is a PPI of stomach acid secretion. Decreasing the overall pH allows the gastric mucosa to heal. D: Flatulence is not affected.
The LPN is preparing a client for discharge and the discharge medications include phenobarbital. Which of these client statements would indicate a need for reinforced teaching about this medication?
- A. I will need to avoid eating excessive leafy greens.
- B. It's best to take this medication with food.
- C. I can't wait to get back to my nightly glass of wine.
- D. I should try to take this medication at the same time every day.
Correct Answer: C
Rationale: Phenobarbital should not be taken with alcohol as it is a barbiturate. Alcohol may increase the sedative effect.
The client is experiencing delirium from substance withdrawal. Which medication, if prescribed prn, should the nurse administer to help calm the client?
- A. Flumazenil_1.PNG
- B. Flumazenil_2.PNG
- C. Flumazenil_3.PNG
- D. Flumazenil_4.PNG
Correct Answer: D
Rationale: Lorazepam (Ativan) depresses the CNS, reducing anxiety and calming the client during withdrawal.