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The nurse is preparing a medication for a patient and observes the date of expiration on the vial occurred 2 months ago. Which of the following actions should the nurse take? What should the nurse do with expired medication?
- A. Discard the medication.
- B. Return the medication to the pharmacy.
- C. Notify the provider.
- D. Give the medication.
Correct Answer: B
Rationale: The correct answer is B: Return the medication to the pharmacy. Expired medication may be less effective or even harmful. By returning it to the pharmacy, the nurse ensures proper disposal, preventing potential harm to patients. Discarding the medication (choice A) is correct, but returning it to the pharmacy is preferred for proper disposal. Notifying the provider (choice C) may be done after returning the medication. Giving the medication (choice D) should never be an option due to safety concerns.
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A nurse is providing teaching to a patient who has a new prescription for levothyroxine. Which of the following instructions should the nurse include? What instructions should the nurse include for levothyroxine?
- A. Take the medication with a meal.
- B. Take the medication in the morning on an empty stomach.
- C. Take the medication at bedtime.
- D. Take the medication with grapefruit juice.
Correct Answer: B
Rationale: The correct answer is B: Take the medication in the morning on an empty stomach. Levothyroxine is best absorbed when taken on an empty stomach, preferably 30 minutes to 1 hour before breakfast. This ensures optimal absorption and effectiveness of the medication. Taking it with a meal (choice A) may interfere with absorption due to food interactions. Taking it at bedtime (choice C) may lead to insomnia or disrupted sleep patterns. Taking it with grapefruit juice (choice D) is not recommended, as grapefruit juice can interfere with the absorption of certain medications. Thus, the most appropriate instruction for the patient is to take levothyroxine in the morning on an empty stomach for optimal efficacy.
History & Physical (0700hrs)
Date: 06/28/0X
• Client presented to the clinic reporting pelvic pain, dysmenorrhea, dyspareunia, and pain with defecation.
• Vaginal examination reveals fixed, palpable nodules with a retroverted uterus.
• Imaging reveals endometrial lesions on the ovaries, uterosacral ligaments, and round ligaments.
• Endometriosis diagnosed.
Provider's Prescriptions (0700hrs)
• Nafarelin 200 mcg: 1 spray intranasally every morning and 1 spray in the opposite nostril every evening.
Nurse's Notes (0700hrs)
• Client reports adherence to nafarelin regimen without missing doses.
• Client verbalizes irritation in the nasal mucosa.
• Reports feeling better overall with decreased dyspareunia.
• Notes decreased pain during bowel movements.
• Reports decreased pelvic pain and the absence of menstruation last month.
• Mentions experiencing headaches, increased acne, and reduced sex drive since starting treatment.
• Client observes a decrease in breast size.
Scenario:
A nurse is caring for a 32-year-old female client who was recently diagnosed with endometriosis. The client is in the clinic for a follow-up visit after beginning nafarelin treatment.
Setting: Clinic
Which of the following manifestations reported by the client should the nurse identify as a therapeutic effect of the nafarelin? (Select all that apply.)
- A. CNS manifestations
- B. Pain level during sexual intercourse
- C. Nasal mucosa changes
- D. Breast changes
- E. Missed previous month's menstrual cycle
- F. Dermatological manifestations
Correct Answer: B,E
Rationale: The correct answers are B and E. Nafarelin is a gonadotropin-releasing hormone (GnRH) agonist used to treat endometriosis by suppressing estrogen production, thereby reducing symptoms like pain during intercourse (choice B) and causing missed menstrual cycles (choice E). These are therapeutic effects. Choices A, C, D, and F are incorrect because CNS manifestations, nasal mucosa changes, breast changes, and dermatological manifestations are not commonly reported therapeutic effects of nafarelin. Thus, options A, C, D, and F can be ruled out.
A nurse is caring for a patient who is postoperative following a bowel resection. Which of the following findings should the nurse report to the provider? Which finding post-bowel resection should the nurse report?
- A. Soft, formed stools
- B. Abdominal distension
- C. Mild incisional pain
- D. Nausea
Correct Answer: B
Rationale: The correct answer is B: Abdominal distension. This finding could indicate a possible complication such as bowel obstruction or ileus post-bowel resection. The nurse should report this symptom promptly to the provider for further evaluation and intervention to prevent potential complications. Soft, formed stools (A) are expected after bowel resection, indicating bowel function is returning. Mild incisional pain (C) is common postoperatively and can be managed with pain medication. Nausea (D) can also be common after surgery but may require monitoring if persistent or severe. There are no additional choices provided, but it is essential for the nurse to prioritize reporting any unusual or concerning findings to ensure the patient's safety and well-being.
A nurse is providing health promotion education to the parents of a toddler. Which information should the nurse include in the teaching?,Which information should be included in toddler health promotion education?
- A. Need for increased caloric intake.
- B. How to establish trust.
- C. Management of tantrums.
- D. How to encourage cooperative play.
- E. Dental care.
Correct Answer: A,C,D,E
Rationale: The correct answer includes information on caloric intake (A) to ensure the toddler's proper growth and development. Management of tantrums (C) is crucial for behavioral management. Encouraging cooperative play (D) fosters social skills. Dental care (E) is essential for oral health. Establishing trust (B) is important but not directly related to health promotion. No information is given for choices F and G.
A nurse is preparing to infuse ampicillin and gentamicin sulfate intravenously. Which resource should the nurse first consult for information on medication compatibility? Which resource should the nurse consult for compatibility?
- A. Hospital pharmacist
- B. Health care provider
- C. Medication sales representative
- D. Nurse manager
Correct Answer: A
Rationale: The correct answer is A: Hospital pharmacist. The pharmacist is the most appropriate resource for medication compatibility information because they have the expertise in drug interactions, contraindications, and compatibility issues. Pharmacists can provide detailed information on how ampicillin and gentamicin sulfate interact when given together intravenously. Consulting a pharmacist ensures patient safety by preventing potential adverse drug reactions. Health care providers may not have detailed knowledge of medication compatibility. Medication sales representatives may have biased information and limited expertise. Nurse managers are not typically trained in pharmacology and drug interactions. Consulting the hospital pharmacist is the best course of action to ensure safe administration of medications.