Nokea
The practical nurse (PN) is obtaining the medical history of a client starting a new prescription for conjugated estrogens PO daily. Which medical condition is not treated by this medication?
- A. Menopausal symptoms
- B. Prostatic cancer
- C. Thromboembolic diseases
- D. Abnormal uterine bleeding
Correct Answer: C
Rationale: Conjugated estrogens, such as Premarin, are not used in the treatment of thromboembolic diseases. These medications are contraindicated in conditions predisposing to thromboembolic diseases due to their association with an increased risk of thromboembolism, stroke, pulmonary embolism, and myocardial infarction. Choices A, B, and D are incorrect because conjugated estrogens are commonly prescribed for managing menopausal symptoms, abnormal uterine bleeding, and certain hormone-responsive cancers, but not for thromboembolic diseases.
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A client with a diagnosis of generalized anxiety disorder is prescribed sertraline. The nurse should instruct the client that this medication may have which potential side effect?
- A. Nausea
- B. Drowsiness
- C. Insomnia
- D. Headache
Correct Answer: A
Rationale: The correct answer is A: Nausea. Sertraline, a selective serotonin reuptake inhibitor (SSRI), is known to commonly cause gastrointestinal side effects such as nausea. It is recommended for clients to take sertraline with food to help minimize this potential side effect. Choice B, Drowsiness, is less commonly associated with sertraline use. Insomnia, choice C, is not a typical side effect of sertraline; in fact, it may help improve sleep in some individuals. Headache, choice D, is also not a common side effect of sertraline.
A client who received a renal transplant three months ago is readmitted to the acute care unit with signs of graft rejection. While taking the client's history, the nurse determines the client has been self-administering St. John's wort, an herbal preparation, on the advice of a friend. What information is most significant about this finding?
- A. Wort can decrease plasma concentration of Cyclospora
- B. Wort can decrease plasma concentration of Tacrolimus
- C. Wort can decrease plasma concentration of Cyclosporine
- D. Wort can decrease plasma concentration of Mycophenolate
Correct Answer: C
Rationale: The most significant information about the client self-administering St. John's wort, an herbal preparation, is that it can decrease the plasma concentration of Cyclosporine. St. John's wort is known to reduce the efficacy of Cyclosporine, which is a common immunosuppressant drug used to prevent transplant rejection. Choices A, B, and D are incorrect because St. John's wort does not affect the plasma concentration of Cyclospora, Tacrolimus, or Mycophenolate.
A client with a diagnosis of schizophrenia is prescribed clozapine. The nurse should monitor the client for which potential side effect?
- A. Agranulocytosis
- B. Dry mouth
- C. Weight gain
- D. Hypersalivation
Correct Answer: A
Rationale: The correct answer is Agranulocytosis. Clozapine is known to potentially cause agranulocytosis, a serious condition characterized by a dangerously low white blood cell count. Monitoring white blood cell counts is crucial to detect this side effect early and prevent complications. Choices B, C, and D are incorrect because dry mouth, weight gain, and hypersalivation are not typically associated with clozapine use. While dry mouth can be a common side effect of some antipsychotic medications, it is not specifically linked to clozapine. Weight gain can occur with certain antipsychotics, but clozapine is more commonly associated with metabolic side effects. Hypersalivation is not a common side effect of clozapine.
A patient with irritable bowel syndrome starts a new prescription for dicyclomine, an anticholinergic medication. The client reports the onset of sensitivity to light and a dry mouth. How should the nurse respond?
- A. Determine if the medication is being taken correctly
- B. Provide instructions on managing these side effects
- C. Schedule an appointment for evaluation by the healthcare provider
- D. Advise stopping the medication until the unpleasant side effects wear off
Correct Answer: B
Rationale: The correct response is to provide instructions on managing these side effects. Sensitivity to light and dry mouth are common side effects of anticholinergic medications like dicyclomine. It is essential for the nurse to educate the patient on strategies to cope with these side effects, such as staying hydrated to address dry mouth and wearing sunglasses to reduce sensitivity to light. Option A is not the priority as the side effects are expected with this medication and do not necessarily indicate incorrect use. Option C is not immediately necessary as the side effects are common and can be managed without a healthcare provider evaluation. Option D is not recommended unless advised by the healthcare provider as abruptly stopping the medication can lead to worsening symptoms or withdrawal effects.
How does omeprazole work in treating a peptic ulcer?
- A. Increasing the production of gastric acid
- B. Neutralizing stomach acid
- C. Coating the stomach lining
- D. Reducing gastric acid secretion
Correct Answer: D
Rationale: Omeprazole is a proton pump inhibitor that works by reducing gastric acid secretion. By inhibiting the enzyme responsible for pumping acid into the stomach, omeprazole helps decrease the acidity level in the stomach, providing relief from peptic ulcers. Option A is incorrect because omeprazole does not increase gastric acid production; instead, it decreases it. Option B is incorrect as omeprazole does not neutralize existing stomach acid but rather reduces its secretion. Option C is incorrect as omeprazole does not coat the stomach lining but acts on reducing acid secretion.