Nokea
The nurse is taking a history from a client in an outpatient clinic. The client has been taking duloxetine (Cymbalta) for fibromyalgia. Which of the following over-the-counter medications would cause the nurse some concern if the client says she is taking it?
- A. aspirin
- B. garlic supplements
- C. vitamin B6
- D. cough medicine with dextromethorphan
Correct Answer: D
Rationale: Dextromethorphan can interact with duloxetine, increasing the risk of serotonin syndrome, a potentially serious condition.
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A woman is admitted to the labor and delivery unit in a sickle cell crisis. Which of the following nursing actions is the HIGHEST priority?
- A. Administer oxygen.
- B. Turn her to the right side.
- C. Provide adequate hydration.
- D. Start antibiotics.
Correct Answer: C
Rationale: adequate hydration is a priority for any client with sickle cell crisis
Which instruction would not be included in the discharge teaching of the client receiving chlorpromazine (Thorazine)?
- A. You will need to wear protective clothing or a sunscreen when you are outside.'
- B. You will need to avoid eating aged cheese.'
- C. You should carry hard candy with you to decrease dryness of the mouth.'
- D. You should report a sore throat immediately.'
Correct Answer: B
Rationale: Avoiding aged cheese is relevant for MAO inhibitors, not chlorpromazine, which does not interact with tyramine-containing foods.
An elderly adult has been admitted with a diagnosis of hypertension with a history of dementia. Which of the following nursing diagnoses has the highest priority for this client?
- A. ineffective coping
- B. activity intolerance
- C. ineffective tissue perfusion
- D. risk for injury
Correct Answer: D
Rationale: Dementia increases fall and injury risk due to impaired judgment and memory, making 'risk for injury' the priority.
The nursing assistant finds a client on the floor. Once the client is safe, which of the following should the nurse do next?
- A. document the event in the client's medical record only
- B. document the event in the client's medical record and file an incident report
- C. document the event in the client's medical record and have the nursing assistant file an incident report
- D. have the nursing assistant file an incident report
Correct Answer: B
Rationale: Falls require documentation in the medical record and an incident report to track safety issues and ensure follow-up.
A client is admitted to the unit 2 hours after an injury with second-degree burns to the face, trunk, and head. The nurse would be most concerned with the client developing what?
- A. Hypovolemia
- B. Laryngeal edema
- C. Hypernatremia
- D. Hyperkalemia
Correct Answer: B
Rationale: Laryngeal edema is a critical concern with facial and head burns due to the risk of airway obstruction.