Nokea
The nurse provides instructions to a client who is taking allopurinol for the treatment of gout. Which statement by the client indicates an understanding of the medication?
- A. I should put ice on my lips if they swell.
- B. I need to take the medication 2 hours after I eat.
- C. I need to drink at least 8 glasses of liquids every day.
- D. I can use an antihistamine lotion if I get a rash that is itchy.
Correct Answer: C
Rationale: Clients taking allopurinol are encouraged to drink 3000 mL of fluid a day. If the client develops a rash, irritation of the eyes, or swelling of the lips or mouth, he or she should contact the primary health care provider because this may indicate hypersensitivity. Allopurinol is to be given with or immediately after meals or milk.
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A client with a history of seizures is prescribed phenytoin (Dilantin). The nurse should instruct the client to report which of the following side effects?
- A. Gingival hyperplasia.
- B. Weight gain.
- C. Insomnia.
- D. Dry skin.
Correct Answer: A
Rationale: Phenytoin commonly causes gingival hyperplasia, which should be reported to manage oral health and adjust treatment if needed.
A client has been diagnosed with atrial fibrillation. The physician ordered warfarin (Coumadin) to be taken on a daily basis. The nurse instructs the client to avoid using which of the following over-the-counter medications while taking warfarin?
- A. Aspirin
- B. Diphenhydramine (Benadryl)
- C. Digoxin (Lanoxin)
- D. Pseudoephedrine (Sudafed)
Correct Answer: A
Rationale: Aspirin increases bleeding risk when taken with warfarin, a blood thinner, and should be avoided. Other listed medications have less significant interactions with warfarin.
A family has been notified that their son is brain dead, and the physician has discussed the possibility of donating organs. The nurse should collaborate with the physician to contact which referral source that is responsible for organ recovery in the United States?
- A. Organ and Tissue Procurement Organizations.
- B. American Transplant Association.
- C. American Hospice Foundation.
- D. American Association of Critical-Care Nurses.
Correct Answer: A
Rationale: Organ and Tissue Procurement Organizations are responsible for coordinating organ recovery in the United States, as they manage the donation process and ensure compliance with regulations.
During your system specific assessment of your client's peripheral pulses, you note that the client's posterior tibia pulse is weak and thready. You would document this finding as:
- A. The client's posterior tibia pulse is Grade B
- B. The client's posterior tibia pulse is Grade C
- C. The client's posterior tibia pulse is 1
- D. The client's posterior tibia pulse is 2
Correct Answer: C
Rationale: A weak and thready pulse is documented as 1+ on a 0-4+ scale, indicating diminished pulse strength.
A client is receiving total parenteral nutrition (TPN). The nurse notices that the bag of TPN solution has been infusing for 24 hours but has $300 \mathrm{~mL}$ of solution left. The nurse should:
- A. Continue the infusion until the remaining 300mL is infused
- B. Change the filter on the tubing and continue with the infusion
- C. Notify the physician and obtain orders to alter the rate of the solution
- D. Discontinue the current solution, change the tubing, and hang a new bag of TPN solution
Correct Answer: D
Rationale: TPN solutions should not hang for more than 24 hours due to infection risk. The nurse should discontinue the current bag, change the tubing, and hang a new bag. Continuing or altering the rate is unsafe.