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The nurse is teaching a client about the newly prescribed medication, esomeprazole. Which statements, if made by the client, would require further teaching? Select all that apply.
- A. I should take this medication with meals.
- B. Long term use of this medication may increase my risk for osteoporosis.
- C. The medication will coat my ulcer so I can eat without pain.
- D. I will need frequent laboratory tests while taking this medication.
- E. I may need to take magnesium supplements while on this medication.
Correct Answer: A,C,D
Rationale: Esomeprazole should be taken before meals, not with them; it reduces acid but does not coat ulcers; and routine lab tests are not typically required. Osteoporosis risk and magnesium supplementation are valid concerns.
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Which of the following clients does the nurse suspect would benefit most from placement of a nasogastric tube?
- A. A 9-year-old client with a femur fracture.
- B. An 82-year-old client with congestive heart failure.
- C. A 65-year-old client on dialysis.
- D. A 52-year-old client with leukemia who is receiving chemotherapy.
Correct Answer: D
Rationale: A client receiving chemotherapy (D) may experience severe nausea and vomiting, necessitating an NG tube for decompression or feeding. The other conditions are less likely to require NG tube placement.
The nurse is assessing a client with acute cholecystitis. Which of the following physical assessment findings would be expected?
- A. Stools that contain blood and mucus
- B. Pain with urination
- C. Episodic upper abdominal pain
- D. Hypoactive bowel sounds
Correct Answer: C
Rationale: Episodic upper abdominal pain (C), often in the right upper quadrant, is a hallmark of acute cholecystitis due to gallbladder inflammation.
The nurse is teaching a client about newly prescribed metoclopramide for nausea and vomiting. Which adverse reaction requires immediate follow-up?
- A. Dystonia
- B. Fever
- C. Drowsiness
- D. Diarrhea
Correct Answer: A
Rationale: Dystonia, an extrapyramidal symptom, is a serious adverse effect of metoclopramide requiring immediate follow-up due to its impact on movement. Fever, drowsiness, and diarrhea are less urgent side effects.
The nurse has instructed self-management strategies for a client diagnosed with gastroesophageal reflux disease (GERD). Which statement by the client would indicate a correct understanding of the teaching?
- A. It's much better for me to wear loose-fitting clothes right now.
- B. I stopped eating grilled chicken and now eat more ground hamburger.
- C. If I wake up with GERD symptoms, I should lower the head of my bed while sleeping.
- D. I should take my prescribed omeprazole after meals.
Correct Answer: A
Rationale: Loose-fitting clothes (A) reduce abdominal pressure, helping manage GERD. Hamburger (B) is high-fat and worsens reflux, lowering the bed (C) increases symptoms, and omeprazole (D) is taken before meals.
The nurse cares for a client who had a liver transplant 48 hours ago. It would be a priority for the nurse to notify the healthcare provider (HCP) if the client has
- A. An increase in oral temperature from 97.8°F (36.6°C) to 98.6°F (37°C).
- B. Rising aspartate aminotransferase (AST) and alanine aminotransferase (ALT) levels.
- C. A moderate amount of serosanguinous drainage to the incision.
- D. Nausea following the administration of oral pain medication.
Correct Answer: B
Rationale: Rising AST and ALT levels (B) indicate possible liver graft dysfunction or rejection, a critical finding requiring immediate HCP notification post-transplant.