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The patient will take a high dose of azithromycin after discharge from the hospital. Which statement by the patient indicates understanding of the teaching?
- A. I may take antacids 2 hours before taking this drug.
- B. I should take acetaminophen for fever or mild pain.
- C. I should expect diarrhea to be a common, mild side effect.
- D. I should avoid dairy products while taking this drug.
Correct Answer: A
Rationale: The correct answer is A. Azithromycin peak levels may be reduced by antacids when taken at the same time, so patients should be cautioned to take antacids 2 hours before or 2 hours after taking the drug. Choice B is incorrect because high-dose azithromycin carries a risk for hepatotoxicity when taken with other potentially hepatotoxic drugs such as acetaminophen. Choice C is incorrect as diarrhea may indicate pseudomembranous colitis and should be reported, not expected as a common mild side effect. Choice D is incorrect; there is no restriction for dairy products while taking azithromycin.
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A client has just regained bowel sounds after undergoing surgery. The physician has prescribed a clear liquid diet for the client. Which of the following items should the nurse ensure is available in the client's room before allowing the client to drink?
- A. Straw
- B. Napkin
- C. Oxygen saturation monitor
- D. Suction equipment
Correct Answer: D
Rationale: After surgery, when a client has just regained bowel sounds and is prescribed a clear liquid diet, the nurse needs to consider the possibility of impaired swallow reflexes due to anesthesia effects, leading to an increased risk of aspiration. Despite checking the gag and swallow reflexes before offering fluids, having suction equipment readily available in the client's room is essential to manage any potential aspiration risk. Therefore, the correct answer is suction equipment (choice D). Choices A, B, and C are incorrect because while a straw, napkin, and oxygen saturation monitor may be useful in other situations, they are not directly related to managing the risk of aspiration associated with offering fluids to a client post-surgery.
A nurse assesses clients on the medical-surgical unit. Which client is at greatest risk for bladder cancer?
- A. A 25-year-old female with a history of sexually transmitted diseases
- B. A 42-year-old male who has worked in a lumber yard for 10 years
- C. A 55-year-old female who has had numerous episodes of bacterial cystitis
- D. An 86-year-old male with a 50-pack-year cigarette smoking history
Correct Answer: D
Rationale: The correct answer is D. The greatest risk factor for bladder cancer is a long history of tobacco use, which is reflected in an 86-year-old male with a 50-pack-year cigarette smoking history. Smoking is a well-established risk factor for developing bladder cancer. Choices A, B, and C are not directly linked to an increased risk of bladder cancer. While sexually transmitted diseases, certain occupational exposures, and recurrent urinary tract infections may pose other health risks, they are not specifically associated with an elevated risk of bladder cancer.
During an assessment on a patient brought to the emergency department for treatment for dehydration, the nurse notes a respiratory rate of 26 breaths/minute, a heart rate of 110 beats/minute, a blood pressure of 86/50 mm Hg, and a temperature of 39.5° C. The patient becomes dizzy when transferred from the wheelchair to a bed. The nurse observes cool, clammy skin. Which diagnosis does the nurse suspect?
- A. Fluid volume deficit (FVD)
- B. Fluid volume excess (FVE)
- C. Mild extracellular fluid (ECF) deficit
- D. Renal failure
Correct Answer: A
Rationale: The nurse should suspect Fluid Volume Deficit (FVD) in this patient. Signs of FVD include elevated temperature, tachycardia, tachypnea, hypotension, orthostatic hypotension, and cool, clammy skin, which align with the patient's assessment findings. Choices B, C, and D are incorrect. Fluid Volume Excess (FVE) typically presents with bounding pulses, elevated blood pressure, dyspnea, and crackles. Mild extracellular fluid (ECF) deficit usually manifests as thirst. Renal failure commonly results in Fluid Volume Excess (FVE) rather than Fluid Volume Deficit (FVD).
The client with chronic kidney disease (CKD) is being taught about the necessary sodium restriction in the diet to prevent edema and hypertension. Which statement by the client indicates more teaching is needed?
- A. I am thrilled that I can continue to eat fast food.
- B. I will cut out bacon with my eggs every morning.
- C. My cooking style will change by not adding salt.
- D. I will probably lose weight by cutting out potato chips.
Correct Answer: A
Rationale: Choice A, 'I am thrilled that I can continue to eat fast food,' indicates a lack of understanding as fast food is typically high in sodium, which is detrimental for individuals with CKD. The client should be advised to avoid fast food due to its high sodium content. Choices B, C, and D demonstrate a good understanding of the need for sodium restriction in the diet to prevent complications associated with CKD. Cutting out bacon, avoiding salt in cooking, and eliminating high-sodium snacks like potato chips are all positive steps towards managing CKD.
After pericardiocentesis for cardiac tamponade, for which signs should the nurse assess the client to determine if tamponade is recurring?
- A. Decreasing pulse
- B. Rising blood pressure
- C. Distant muffled heart sounds
- D. Falling central venous pressure (CVP)
Correct Answer: C
Rationale: After pericardiocentesis for cardiac tamponade, the nurse should assess for distant muffled heart sounds that were noted before the procedure. If these sounds return, it could indicate recurring pericardial effusion and potential tamponade. Therefore, the correct answer is the return of distant muffled heart sounds (Option C). Decreasing pulse (Option A) and falling central venous pressure (Option D) are not specific signs of recurring tamponade. Rising blood pressure (Option B) is also not a typical sign of tamponade recurrence; in fact, hypotension is more commonly associated with tamponade.