Nokea
The nurse is preparing to administer the client's medication for treatment of TB. Which medication, if on the client's MAR, should the nurse plan to administer?
- A. Isoniazid
- B. Fluconazole
- C. Azithromycin
- D. Acyclovir
Correct Answer: A
Rationale: A: Isoniazid (INH) is an antimycobacterial medication affecting bacterial cell wall synthesis; it is used in the treatment of TB or other mycobacterial infections. B: Fluconazole (Diflucan) is an antifungal agent that inhibits synthesis of fungal sterols, a necessary component of the cell membrane. C: Azithromycin (Zithromax) is a macrolide antibiotic that is bacteriostatic against susceptible bacteria and is usually used for treating lower respiratory tract infections, skin infections, acute otitis media, tonsillitis, or Mycobacterium avium. D: Acyclovir (Zovirax) is an antiviral agent limited to treatment of herpes viruses.
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The nurse applies a fentanyl transdermal patch to the client for the first time. Shortly after application, the client is experiencing pain. Which nursing action is most appropriate?
- A. Remove the transdermal patch and apply a new one.
- B. Administer a short-acting opioid analgesic medication.
- C. Rub the transdermal patch to enhance drug absorption.
- D. Call the HCP to request a higher-dosed fentanyl patch.
Correct Answer: B
Rationale: A: Removing the patch is unnecessary; effective analgesia may take 12 to 24 hours. B: The nurse should administer a short-acting opioid analgesic. When the first fentanyl (Duragesic) transdermal patch is applied, effective analgesia may take 12 to 24 hours because absorption is slow. C: Transdermal patches should not be rubbed to enhance absorption; it can cause the delivery of the medication to fluctuate. D: It is premature to request a higher dose of fentanyl.
The client has a new prescription for metoclopramide. The nurse notifies the HCP because the client has a contraindication for metoclopramide use. Which information in the client's medical record most likely prompted the nurse's notification of the HCP?
- A. Use of nasogastric suctioning
- B. History of diabetes mellitus
- C. History of seizure disorders
- D. Chemotherapy treatment for cancer
Correct Answer: C
Rationale: A: The use of NG suctioning alone would not prevent metoclopramide use. Metoclopramide can be administered through the NG tube; the tube is then clamped for an hour after administration until absorption occurs. B: Metoclopramide should be used with caution with DM, but it is not contraindicated. C: The client's history of a seizure disorder would contraindicate the use of metoclopramide. Because metoclopramide (Reglan) blocks dopamine receptors in the chemoreceptor trigger zone of the CNS, it is contraindicated in seizure disorders. D: Metoclopramide is used in the treatment of nausea and vomiting for clients receiving chemotherapy.
Which of the following would likely not be a barrier to learning?
- A. a client who took Ambien an hour ago
- B. a bipolar client currently in a manic phase
- C. a client who states they are not interested
- D. a client with dysphagia
Correct Answer: D
Rationale: Dysphagia may be a barrier to communication but not to learning. Barriers to learning include an altered mental status, taking sedative medications, and lack of motivation to learn.
The nurse is teaching the client newly started on propranolol for acute situational anxiety disorder. In addition to treating the client's anxiety, the nurse should inform the client that propranolol's use is effective in treating which associated problem?
- A. Bradycardia
- B. Hand tremors
- C. Muscle spasms
- D. Hypertensive crisis
Correct Answer: B
Rationale: Propranolol (Inderal), a beta blocker, has been shown to be effective in ameliorating the somatic symptoms of anxiety such as hand tremor.
The child with CF is receiving albuterol. Which response should the nurse expect if albuterol is achieving the desired therapeutic effect?
- A. Increased heart rate
- B. Improved weight gain
- C. Fewer hospitalizations
- D. Fewer adventitious lung sounds
Correct Answer: D
Rationale: A: Albuterol may increase HR, but this is not the desired therapeutic effect. B: Weight should not be affected by albuterol. C: The use of a bronchodilator has not been demonstrated to decrease hospitalization frequency. D: The desired therapeutic effect of a bronchodilator such as albuterol (Proventil) is a reduction in adventitious (abnormal) breath sounds.