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The nurse is preparing to administer Azithromycin, and the pharmacy has provided the drug in a powder form that requires reconstitution connected to a saline piggyback. Which of the following is least concerning when preparing the medication?
- A. The expiration date on the powder vial is the same as the current date.
- B. The brand/trade name is not listed on the vial.
- C. The storage instructions on the vial says 'store at room temperature', and the vial is very cold to the touch indicating it has been taken out of a freezer.
- D. The bag of saline is leaking.
Correct Answer: B
Rationale: The brand or trade name is not required to be on the medication label if the generic name is present. The nurse should check that the medication is not expired and that it has been stored according to the storage instructions. If the saline bag is leaking, it may indicate that the container is damaged and the fluid may not be sterile.
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The client with chronic, stable angina telephones the clinic nurse and reports a headache lasting for several days after taking one dose of isosorbide mononitrate. The client also reports symptoms of orthostatic hypotension and palpitations. Which is the nurse's best action?
- A. Recommend that the client make an appointment with the health care provider.
- B. Have the client retime the dose for a later time when the client is more active.
- C. Instruct the client to take two acetaminophen 325-mg tablets with the next dose.
- D. Teach Immaculate that the headaches will subside over time with continued use.
Correct Answer: A
Rationale: A: Severe headaches, orthostatic hypotension, and palpitations may be a sign of isosorbide mononitrate (Imdur) toxicity; thus, the client should be evaluated by an HCP. Other signs of toxicity include syncope, dizziness, blurred vision, and light-headedness. B: Isosorbide mononitrate should be taken in the morning to improve blood flow to the heart and prevent angina attacks that can occur due to increased oxygen demand from activity. C: A headache (but not a severe headache) can be treated with or prevented by analgesics taken either before or at the same time as the isosorbide mononitrate. D: Although the headaches will subside over time, the client is experiencing symptoms of isosorbide mononitrate toxicity.
The HCP prescribes risperidone to manage the hallucinations of the client diagnosed with paranoid schizophrenia. Which client statements reflect a need for further education regarding the medication's side effects? Select all that apply.
- A. Diarrhea may be a problem for me.
- B. I'll most likely develop high blood pressure.
- C. Being too nervous is a side effect of my medicine.
- D. I will need to watch what I eat so I won't gain weight.
- E. Getting up too quickly when I'm sitting can make me dizzy.
- F. I will need to be careful driving because this can make me drowsy.
Correct Answer: A,B
Rationale: Constipation, not diarrhea, and hypotension, not hypertension, are side effects of risperidone, indicating a need for further education.
The client is being treated with Clozapine. Which findings during the nurse's assessment indicate that the client is experiencing adverse effects of Clozapine? Select all that apply.
- A. Dehydration
- B. Agranulocytosis
- C. Increasing anxiety
- D. Extreme salivation
- E. Blood glucose 192 mg/dL
Correct Answer: B,D,E
Rationale: Agranulocytosis, hypersalivation, and hyperglycemia are adverse effects of clozapine (Clozaril).
The HCP prescribes amoxicillin for the 8-month-old with acute otitis media that has not resolved. Which statement to the parents is correct regarding the primary purpose of amoxicillin?
- A. It will reduce the child's fever.
- B. It will reduce the child's severe ear pain.
- C. It will shrink swollen tissue in the Eustachian tube.
- D. It will treat the probable organism, Haemophilus influenzae.
Correct Answer: D
Rationale: A: As the infection is treated, the fever will be reduced, but this is not the primary reason for treatment with amoxicillin. B: Treating the ear infection will reduce the pain, but that is not the primary purpose for treatment with amoxicillin. C: Reducing inflammation of the eustachian tube will occur, but this is not the primary purpose for treatment with amoxicillin. D: Acute otitis media is frequently caused by the Haemophilus influenzae and Streptococcus pneumoniae bacteria. The primary purpose of amoxicillin (Amoxil) is to treat the infection caused by these two organisms.
The client taking carbamazepine XR for seizure control reports that pieces of the medication are being passed into the stool. Which action by the nurse is most important?
- A. Report this to the health care provider.
- B. Reassure the client that this is normal.
- C. Collect the stool for laboratory analysis.
- D. Document the findings in the medical record.
Correct Answer: B
Rationale: A: It is inappropriate to report an expected finding to the HCP. B: Carbamazepine XR (Tegretol XR) is a sustained-release medication with a coating that is not absorbed but is excreted in feces and may be visible in stool. The nurse should reassure the client that this is normal. C: Collecting the stool for laboratory analysis is not necessary because the coating is not absorbed but excreted in the stool. D: The nurse should document the client teaching but usually would not document the presence of the coating in the client's stool.