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The patient is being educated on taking hydrochlorothiazide. Which statement by the patient indicates a need for further teaching?
- A. I may need additional sodium and calcium while taking this medication.
- B. I should consume plenty of fruits and vegetables while taking this drug.
- C. I should be cautious when getting up from a bed or chair while on this medication.
- D. I will take the medication in the morning to reduce certain side effects.
Correct Answer: A
Rationale: The correct answer is A because patients do not require extra sodium or calcium while taking hydrochlorothiazide, a thiazide diuretic. This medication actually promotes the excretion of sodium and water. Choices B, C, and D are correct statements regarding the use of hydrochlorothiazide. Patients are encouraged to have a diet rich in fruits and vegetables, be careful with position changes due to potential orthostatic hypotension, and take the medication in the morning to reduce the need for frequent urination during nighttime.
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A patient asks the nurse about taking calcium supplements to avoid hypocalcemia. The nurse will suggest that the patient follow which instruction?
- A. Take a calcium and vitamin D combination supplement.
- B. Take calcium along with phosphorus to improve absorption.
- C. Take calcium with antacids to reduce stomach upset.
- D. Use aspirin instead of acetaminophen when taking calcium.
Correct Answer: A
Rationale: The correct answer is to take a calcium and vitamin D combination supplement. Vitamin D enhances the absorption of calcium in the body, making it an essential component for calcium utilization. Choice B is incorrect because calcium and phosphorus have an inverse relationship, where an increased level of one mineral decreases the level of the other, so taking them together may not be beneficial. Choice C is incorrect because antacids often contain magnesium, which can promote calcium loss instead of absorption. Choice D is incorrect because aspirin can alter vitamin D levels and interfere with calcium absorption, so it is not recommended when taking calcium supplements.
When preparing to examine a client's skin using a Wood light, what should the nurse do to facilitate this procedure?
- A. Darken the examining room
- B. Administer a local anesthetic
- C. Obtain a signed informed consent
- D. Shave the skin and scrub it with povidone-iodine (Betadine)
Correct Answer: A
Rationale: When using a Wood light to examine the skin, the nurse should darken the examining room. This is necessary because the Wood light emits long-wavelength UV light, which is better visualized in a darkened environment. Administering a local anesthetic (Choice B) is not needed for this procedure. Obtaining a signed informed consent (Choice C) is not directly related to using a Wood light for skin examination. Shaving the skin and scrubbing it with povidone-iodine (Betadine) (Choice D) is not required and may not be appropriate for this type of skin examination.
A client with acute kidney injury has a blood pressure of 76/55 mm Hg. The health care provider ordered 1000 mL of normal saline to be infused over 1 hour to maintain perfusion. The client is starting to develop shortness of breath. What is the nurse's priority action?
- A. Calculate the mean arterial pressure (MAP).
- B. Ask for insertion of a pulmonary artery catheter.
- C. Take the client's pulse.
- D. Slow down the normal saline infusion.
Correct Answer: D
Rationale: The nurse should recognize that the client may be developing fluid overload and respiratory distress due to the rapid normal saline infusion. The priority action is to slow down the infusion to prevent worsening respiratory distress and potential fluid overload. While calculating the mean arterial pressure (MAP) is important to assess perfusion, addressing the immediate respiratory distress takes precedence. Inserting a pulmonary artery catheter would provide detailed hemodynamic information but is not the initial step in managing acute respiratory distress. Monitoring vital signs, including the client's pulse, is crucial after adjusting the intravenous infusion to ensure a safe response to the intervention.
The nurse is preparing to administer the first dose of intravenous ceftriaxone (Rocephin) to a patient. When reviewing the patient's chart, the nurse notes that the patient previously experienced a rash when taking amoxicillin. What is the nurse's next action?
- A. Administer the drug and observe closely for hypersensitivity reactions.
- B. Ask the provider whether a cephalosporin from a different generation may be used.
- C. Contact the provider to report drug hypersensitivity.
- D. Notify the provider and suggest an oral cephalosporin.
Correct Answer: A
Rationale: When a patient has a history of a rash with amoxicillin, a beta-lactam antibiotic like ceftriaxone should be administered cautiously due to a possible cross-reactivity. The nurse should still administer the drug but closely monitor the patient for any signs of hypersensitivity reactions. Asking for a different generation of cephalosporin or suggesting an oral form does not address the potential cross-reactivity issue. Contacting the provider to report drug hypersensitivity would delay care when the patient needs immediate treatment.
A client is tested for HIV with the use of an enzyme-linked immunosorbent assay (ELISA), and the test result is positive. The nurse should tell the client that:
- A. HIV infection has been confirmed
- B. The client probably has an opportunistic infection
- C. The test will need to be confirmed with the use of a Western blot
- D. A positive test is a normal result and does not mean that the client is infected with HIV
Correct Answer: C
Rationale: When an ELISA test for HIV is positive, it is essential to confirm the result with a Western blot. The Western blot is the confirmatory test for HIV. Choice A is incorrect because a positive ELISA test does not confirm HIV infection. Choice B is incorrect as it assumes a different diagnosis. Choice D is incorrect because a positive ELISA test does indicate potential HIV infection and requires confirmation.