Nokea
The nurse is teaching a client about a newly prescribed doxycycline. Which of the following statements, if made by the client, would require further teaching? Select all that apply.
- A. I should take this medication with milk or cheese.
- B. If I develop foul-smelling diarrhea I should contact my doctor.
- C. I need to wear sunscreen outdoors while taking this medication.
- D. I can stop this medication when I feel better.
- E. I should take this medication on an empty stomach.
Correct Answer: A,D
Rationale: Doxycycline should not be taken with dairy products like milk or cheese (Choice A) because calcium can bind to the medication and reduce its absorption. Choice D is incorrect because antibiotics like doxycycline should be taken for the full prescribed course to prevent resistance and ensure complete treatment. Choice B is correct; foul-smelling diarrhea could indicate a serious infection like Clostridium difficile. Choice C is correct; doxycycline causes photosensitivity, requiring sunscreen. Choice E is correct; taking doxycycline on an empty stomach improves absorption.
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The nurse anticipates that a client who has received propofol (Diprivan) as the induction and maintenance agent for general anesthesia will most likely experience:
- A. Minimal nausea and vomiting.
- B. Hypotension.
- C. Slow induction of anesthesia.
- D. Small tremors of the skeletal muscles.
Correct Answer: A
Rationale: Propofol is associated with minimal postoperative nausea and vomiting, making it a preferred agent for many surgeries, especially outpatient procedures.
A client who has been taking carisoprodol (Soma) at home for a fractured arm is admitted with a blood pressure of 80/50 mm Hg, a pulse rate of 115 bpm, and respirations of 8 breaths/minute and shallow. The nurse interprets these findings as indicating which of the following?
- A. Expected common adverse effects.
- B. Hypersensitivity reaction.
- C. Possible habituating effect.
- D. Hemorrhage from gastrointestinal irritation.
Correct Answer: B
Rationale: These vital signs suggest a hypersensitivity reaction, a serious adverse effect of carisoprodol.
The nurse is assessing clients at a health fair. Which client is at greatest risk for coronary artery disease?
- A. A 32-year-old female with mitral valve prolapse who quit smoking 10 years ago.
- B. A 43-year-old male with a family history of CAD and cholesterol level of 158.
- C. A 56-year-old male with an HDL of 60 who takes atorvastatin (Lipitor).
- D. A 65-year-old female who is obese with an LDL of 188.
Correct Answer: D
Rationale: Obesity and elevated LDL (188) are significant risk factors for coronary artery disease. The other clients have lower-risk profiles due to younger age, smoking cessation, or controlled lipids.
A client with multiple sclerosis (MS) is receiving baclofen (Lioresal). The nurse determines that the drug is effective when it achieves which of the following?
- A. Induces sleep.
- B. Stimulates the client's appetite.
- C. Relieves muscular spasticity.
- D. Reduces the urine bacterial count.
Correct Answer: C
Rationale: Baclofen is a muscle relaxant used in MS to relieve spasticity, its primary therapeutic effect. It does not induce sleep, stimulate appetite, or reduce bacterial counts.
In order to prevent recurrent vasospastic episodes with Raynaud's phenomenon, the nurse should instruct the client to:
- A. Keep the hands and feet elevated as much as possible
- B. Use a vibrating massage device on the hands
- C. Wear gloves when obtaining food from the refrigerator
- D. Increase coffee intake to 2 cups per day
Correct Answer: C
Rationale: Wearing gloves when obtaining food from the refrigerator prevents cold-triggered vasospasm in Raynaud's. Elevation is irrelevant, vibrating devices may worsen symptoms, and coffee (caffeine) can cause vasoconstriction, increasing episodes.