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The nurse is reviewing the client's medication list illustrated, prepared by the client's daughter. The nurse is most concerned about which finding?
- A. Some medication doses are missing.
- B. Some administration routes are missing.
- C. Some medications are being duplicated.
- D. Some medications have drug-drug interactions.
Correct Answer: C
Rationale: A: Missing doses of medication is important to address; however, duplicate medications should be addressed first. B: It is important to address the administration routes, but the duplication of medications is the priority to address. C: Hydrochlorothiazide + captopril (Capozide) is a combination product. The nurse should first determine if the client is taking the combination product along with the individual products due to the potential for overdosing. The client may be clear regarding the dose and the route but may not realize that two medications were replaced with one combination product. D: Drug-drug interactions are important to address and should be addressed, but the duplicate medications are the priority.
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Trimethoprim-sulfamethoxazole is prescribed for the child who develops a UTI. What information should the nurse address when teaching the parents about administering the medication? Select all that apply.
- A. Weigh the child daily in the morning.
- B. Take the child's temperature once daily.
- C. Encourage the child to drink plenty of fluids.
- D. Administer the medication at the prescribed times.
- E. If a rash occurs, report this immediately to the HCP.
Correct Answer: C,D,E
Rationale: A: Weighing is unnecessary; it is important with medications that affect fluid balance, but not with an antibiotic. B: Monitoring temperature would be important to evaluate the effectiveness of antipyretic medications. C: Fluids should be increased to dilute bacterial toxins and increase urinary output. D: The medication should be given in the exact amount at the times directed to maintain a therapeutic blood level. If the therapeutic blood level falls, organisms can build a resistance to the medication. E: Trimethoprim-sulfamethoxazole (Bactrim) is a sulfonamide antibiotic. A rash can indicate an allergy to sulfonamides.
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.
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.
Which of these medications has the least risk of causing tinnitus?
- A. Aspirin
- B. Lasix
- C. Gentamicin
- D. Fluoxetine
Correct Answer: D
Rationale: Gentamicin, Lasix, and Aspirin are all ototoxic drugs that have a potential side effect of causing tinnitus, a ringing in the ear. Fluoxetine, an SSRI, is not typically associated with tinnitus.
The nurse is assessing the client with herpes zoster. The nurse determines that acyclovir is an effective treatment when which finding is noted?
- A. Drying and crusting of genital lesions
- B. Crusting and healing of vesicular skin lesions
- C. Urticaria decreased and pruritus relieved
- D. Decrease in intensity of chicken pox lesions
Correct Answer: B
Rationale: A: Drying and crusting of genital lesions would indicate acyclovir's effectiveness for treating genital herpes, not herpes zoster. B: Herpes zoster produces painful vesicular skin eruptions along the course of a nerve. Crusting and healing of the vesicular skin lesions indicate that acyclovir (Zovirax) is effective. C: Urticaria (swollen, raised areas) and pruritus (itching) are not symptoms of herpes zoster. D: The lesions of chicken pox are generalized, whereas herpes zoster lesions occur along the course of a nerve. Herpes zoster occurs when the chicken pox (varicella zoster) virus that has incorporated itself into nerve cells is reactivated years after the initial infection, but it is not chicken pox.