Nokea
The nurse is receiving a report from an ER nurse about a client. Which of the following statements requires additional follow-up?
- A. The client said they have been taking aspirin, but I'm not sure for how long or how much.
- B. The client frequently takes antacids, but they have not taken any in the last three days.
- C. The client stopped taking ibuprofen after developing gastric ulcers.
- D. The client takes Antabuse and has stopped using mouthwash.
Correct Answer: A
Rationale: Aspirin can have an impact on the patient's bleeding risk, so the amount and frequency is important to know. Antacids can change the gastric pH and impact medication absorption, so the nurse should note when they are last taken. Ibuprofen can cause or exacerbate gastric ulcers. Clients who take Antabuse should avoid alcohol in all forms, including avoiding over-the-counter cough medication and mouthwash.
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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.
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 major electrolytes in the extracellular fluid are:
- A. potassium and chloride.
- B. potassium and phosphate.
- C. sodium and chloride.
- D. sodium and phosphate.
Correct Answer: C
Rationale: Sodium and chloride are the major electrolytes in the extracellular fluid.
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.
You are caring for a 78-year-old woman who is wondering why she was diagnosed with glaucoma. Although she has several risk factors, which of these is not one of them?
- A. age
- B. blood pressure reading of 143/89
- C. Mexican-American heritage
- D. 20/80 vision
Correct Answer: D
Rationale: Age over 60 and Mexican-American ancestry are both risk factors for glaucoma. Elevated blood pressure also is a risk factor as it can cause optic nerve damage. 20/80 vision, while poor, is not a causal factor for glaucoma.