Nokea
The nurse is preparing to administer the anti-ulcer gastrointestinal agent sucralfate to a patient with peptic ulcer disease. What should be included in this patient’s care plan?
- A. Administer sucralfate once daily, preferably at bedtime.
- B. Give sucralfate on an empty stomach.
- C. Monitor for a secondary Candida infection.
- D. Monitor for electrolyte imbalances.
Correct Answer: B
Rationale: Sucralfate forms a protective barrier over ulcers and should be given on an empty stomach (B), 1 hour before meals or at bedtime, for optimal efficacy. Once-daily dosing (A) is incorrect; it’s typically 4 times daily. Candida infection (C) and electrolyte imbalances (D) are not associated with sucralfate.
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After taking orlistat for one week, a female patient tells the home health nurse that she is experiencing increasingly frequent oily stools and gas. What action should the nurse take?
- A. Ask the patient to describe her dietary intake history for the last several days.
- B. Advise the patient to stop taking the drug and contact her healthcare provider.
- C. Instruct the patient to increase her intake of saturated fats over the next week.
- D. Obtain a stool specimen to evaluate for occult blood and fat content.
Correct Answer: A
Rationale: Orlistat inhibits fat absorption, causing oily stools and gas if dietary fat is high. Assessing dietary intake (A) identifies the cause. Stopping the drug (B) is premature. Increasing fats (C) worsens symptoms. Stool testing (D) is unnecessary for known side effects.
A patient in a residential treatment facility uses a fluticasone propionate and salmeterol discus inhalation system to manage asthma. This system delivers an inhaled powdered form of these combined medications. What instruction should the nurse provide to this patient’s caregivers?
- A. Instruct the patient to exhale rapidly into the mouthpiece when using the discus.
- B. Explain that the patient should not use the discus more than twice daily.
- C. Inform that patients using the discus may experience a decrease in blood pressure.
- D. Suggest offering the discus to the patient for use during an acute asthma attack.
Correct Answer: B
Rationale: Fluticasone/salmeterol is a maintenance therapy, used twice daily (B). Exhaling into the mouthpiece (A) is incorrect; inhalation is required. Hypotension (C) isn’t a common side effect. It’s not for acute attacks (D), which require rescue inhalers.
A female patient with multiple sclerosis reports less fatigue and improved memory since she started using the herbal supplement, ginkgo biloba. What is the most important information for the nurse to include in the teaching plan for this patient?
- A. Nausea and diarrhea can occur when using this supplement.
- B. Ginkgo biloba use should be limited and not taken during pregnancy.
- C. Aspirin and non-steroidal anti-inflammatory drugs interact with ginkgo.
- D. Anxiety and headaches increase with the use of ginkgo biloba.
Correct Answer: C
Rationale: This question is identical to Question 39. Ginkgo biloba’s interaction with aspirin/NSAIDs (C) increases bleeding risk, a critical teaching point. Other side effects (A, D) and pregnancy limits (B) are less urgent. Note: Duplicate question; consider removing.
The nurse initiates an infusion of piperacillin-tazobactam for a client with a urinary tract infection. Five minutes into the infusion, the client reports not feeling well. Which client manifestation should the nurse identify as a reason to stop the infusion?
- A. Hypertension.
- B. Scratchy throat.
- C. Bradycardia.
- D. Pupillary constriction.
Correct Answer: B
Rationale: A scratchy throat (B) may indicate an allergic reaction, potentially anaphylaxis, requiring immediate cessation of the piperacillin-tazobactam infusion and assessment. Hypertension (A), bradycardia (C), and pupillary constriction (D) are not typical signs of an allergic response to this antibiotic.
The nurse administers naloxone to a patient with opioid-induced respiratory depression. An hour later, the nurse finds the patient has a respiratory rate of 4 breaths/minute, oxygen saturation of 75%, and is unresponsive. What action should the nurse take?
- A. Administer a second dose of naloxone.
- B. Prepare to assist with chest tube insertion.
- C. Determine Glasgow Coma Scale score.
- D. Initiate cardiopulmonary resuscitation (CPR).
Correct Answer: D
Rationale: Severe respiratory depression (4 breaths/min), hypoxia (75% SpO₂), and unresponsiveness require immediate CPR (D) to restore circulation/oxygenation. A second naloxone dose (A) may be needed but is secondary. Chest tubes (B) are irrelevant. Glasgow scoring (C) delays critical intervention.