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The nurse is teaching a patient about taking aspirin. Which are important points to include? (Select all that apply.)
- A. Advise the patient to avoid alcohol while taking aspirin.
- B. Instruct the patient to take aspirin before meals on an empty stomach.
- C. Instruct the patient to inform the dentist of the aspirin dosage before having dental work.
- D. Instruct the patient to inform the surgeon of the aspirin dosage before having surgery.
Correct Answer: D
Rationale: Aspirin is an antiplatelet agent that can increase the risk of bleeding, especially when combined with alcohol or during invasive procedures like dental work or surgery. Patients should avoid alcohol to reduce the risk of gastrointestinal bleeding. Additionally, informing healthcare providers about aspirin use is crucial to prevent excessive bleeding during procedures. Taking aspirin on an empty stomach is not recommended, as it can increase the risk of gastric irritation. Therefore, the correct teaching points are to avoid alcohol, inform the dentist, and inform the surgeon about aspirin use.
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The nurse is administering Penicillin to a patient who has tested positive for strep throat. The nurse knows to look for which of the following adverse e昀昀ects as a sign of an acute allergic reaction?
- A. blurred vision
- B. tinnitus
- C. skin rash/hives
- D. vomiting
Correct Answer: C
Rationale: An acute allergic reaction to Penicillin can present with symptoms such as skin rash or hives. This is a common sign of an allergic reaction and can indicate the patient is having an adverse response to the medication. It is essential for the nurse to monitor the patient closely for any signs of allergic reactions, including hives, as they can quickly progress to more severe reactions such as anaphylaxis. Other adverse effects listed in the choices, such as blurred vision, tinnitus, and vomiting, are not typically associated with an acute allergic reaction to Penicillin.
Which of the following diuretics inhibits sodium reabsorption in the kidneys while saving K+ and Hydrogen ions?
- A. Spironolactone
- B. Furosemide
- C. Hydrochlorothiazide
- D. Bumetanide
Correct Answer: A
Rationale: Spironolactone is a potassium-sparing diuretic, which means it inhibits sodium reabsorption in the kidneys, while saving potassium and hydrogen ions. It accomplishes this by acting as an aldosterone antagonist, blocking the action of aldosterone. Aldosterone is a hormone that normally promotes sodium reabsorption in the kidneys and leads to potassium and hydrogen ion excretion. By inhibiting aldosterone, spironolactone promotes sodium excretion while conserving potassium and hydrogen ions.
The nurse is caring for a young patient with a closed head injury who has an intracranial pressure of 35 (normal <20) and serum osmolality of 330 mOsm/kg. The nurse would anticipate which action?
- A. Administration of mannitol
- B. Withholding mannitol at this time, but taking other measures to reduce intracranial pressure
- C. Administration of sodium nitroprusside
- D. Taking no action at this time because the patient has a serum osmolality of 330, which will offset the effects of the elevated intracranial pressure
Correct Answer: B
Rationale: Mannitol is an osmotic diuretic used to reduce intracranial pressure (ICP) by drawing fluid out of the brain tissue. However, it should be used cautiously in patients with elevated serum osmolality, as it can exacerbate hyperosmolality and lead to renal failure or other complications. In this case, the patient's serum osmolality is already high (330 mOsm/kg), so mannitol should be withheld, and other measures to reduce ICP, such as elevating the head of the bed, maintaining proper oxygenation, and avoiding hypercapnia, should be prioritized. Sodium nitroprusside (C) is used for hypertension, not ICP, and taking no action (D) is inappropriate given the elevated ICP.
Barbiturates are contraindicated in a dental patient with: II. emphysema III. Undiagnosed severe pain III. hypertension IV. Acute intermittent porphyria
- A. I, III & IV
- B. I & IV only
- C. II & III only
- D. II only
Correct Answer: A
Rationale: Barbiturates are central nervous system depressants that can exacerbate conditions such as emphysema, hypertension, and acute intermittent porphyria.
The patient is discharged home and returns to the emergency department 4 days later. The patient is admitted to the ICU with acute decompensated HF with dyspnea at rest. The nurse anticipates administration of which medication?
- A. Atropine
- B. Carvedilol (Coreg)
- C. Lisinopril (Prinivil)
- D. Nesiritide (Natrecor)
Correct Answer: D
Rationale: In the scenario described, the patient presents with acute decompensated heart failure (HF) with dyspnea at rest, indicating severe symptoms. Nesiritide, a recombinant B-type natriuretic peptide, is commonly used in the management of acute decompensated HF to improve symptoms of dyspnea and congestion. It acts as a vasodilator and promotes natriuresis and diuresis, helping to alleviate the symptoms of heart failure exacerbation. While other medications like Carvedilol (Coreg) and Lisinopril (Prinivil) are commonly used in chronic HF management, in this acute scenario with severe symptoms, Nesiritide would be the appropriate medication to anticipate for administration in the ICU setting. Atropine is not indicated for acute decompensated heart failure.