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What is the responsibility of the nurse related to the patient's drug therapy? Select all that apply.
- A. Teaching the patient how to cope with therapy to ensure the best outcome.
- B. Altering the drug regime to optimize the outcome.
- C. Evaluating the effectiveness of therapy.
- D. Providing therapy as well as medications.
- E. Recommending over-the-counter medications to treat adverse effects of prescription drug therapy.
Correct Answer: A,C
Rationale: The correct answers are A and C. A nurse's responsibility related to a patient's drug therapy includes teaching the patient how to cope with therapy for optimal outcomes (A) and evaluating the effectiveness of the therapy (C). Teaching the patient ensures they understand how to take medications correctly and manage any side effects. Evaluating effectiveness allows for adjustments in the treatment plan if needed. Choices B, D, and E are incorrect. B - altering the drug regime should be done by the prescribing healthcare provider, not the nurse. D - providing therapy is beyond the scope of a nurse's responsibilities, as they focus on administering medications and supporting the patient. E - recommending over-the-counter medications falls under the purview of a pharmacist or physician, not a nurse.
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A patient diagnosed with Heart Failure would like the nurse to explain what the diagnosis means. How will the nurse explain heart failure?
- A. The heart muscle cannot pump effectively, causing a backup of blood.
- B. Increased protein leads to reduced oncotic pressure and inability to pull the fluid into the system.
- C. The hydrostatic pressure pushing fluids out of the capillary is lower than the oncotic pressure.
- D. The decrease in venous pressure from the backup of blood increases hydrostatic pressure.
Correct Answer: A
Rationale: The correct answer is A: The heart muscle cannot pump effectively, causing a backup of blood. This is the most accurate explanation of heart failure. In heart failure, the heart is unable to pump blood efficiently, leading to a backup of blood in the circulatory system. This can result in symptoms such as shortness of breath, fatigue, and fluid retention.
Explanation for why the other choices are incorrect:
B: Increased protein leading to reduced oncotic pressure is not a direct cause of heart failure.
C: This choice describes the forces involved in fluid movement, not the primary mechanism of heart failure.
D: Heart failure causes a backup of blood, which in turn increases venous pressure, not the other way around.
In summary, choice A is correct as it directly addresses the primary issue of heart failure, while the other choices focus on different physiological processes not directly related to heart failure.
The patient newly diagnosed with epilepsy asks the nurse to explain the meaning of the diagnosis. What is the nurse's best response?
- A. Epilepsy is the clonic-tonic muscle contraction with the potential to cause injury.
- B. Epilepsy is a convulsive disorder caused by electrical discharge in the muscle.
- C. Epilepsy is a single disease.
- D. Epilepsy is characterized by sudden discharge of electrical energy.
Correct Answer: D
Rationale: The correct answer is D because epilepsy is defined by sudden discharges of electrical energy in the brain leading to seizures. This explanation is accurate and specific to the condition. Choice A is incorrect because epilepsy encompasses various types of seizures, not just clonic-tonic muscle contractions. Choice B is incorrect as it simplifies epilepsy to being solely convulsive, disregarding non-convulsive seizures. Choice C is incorrect because epilepsy is a spectrum of disorders.
A patient is admitted to the emergency department with severe recurrent convulsive seizures. Would the nurse expect to order for the use in emergency control of status epileptic?
- A. Ethosuximide (Zarontin).
- B. Diazepam (Valium).
- C. Phenobarbital (Luminal).
- D. Phenytoin (Dilantin).
Correct Answer: B
Rationale: The correct answer is B: Diazepam (Valium). In emergency situations of status epilepticus, diazepam is the preferred medication for immediate control of seizures due to its fast onset of action and efficacy in stopping prolonged seizures. Diazepam acts by enhancing the effect of gamma-aminobutyric acid (GABA) in the brain, which inhibits excessive neuronal activity. Ethosuximide (A) is used for absence seizures, not convulsive seizures. Phenobarbital (C) and phenytoin (D) have slower onset of action and are not ideal for immediate control of seizures.
The parent of a 5-year-old child asks the nurse to recommend an over-the-counter pain medication for the child. Which analgesic will the nurse recommend?
- A. Acetaminophen (Tylenol).
- B. Ibuprofen (Motrin).
- C. Aspirin (Ecotrin).
- D. Diflunisal (Dolobid).
Correct Answer: A
Rationale: The correct answer is A: Acetaminophen (Tylenol). Acetaminophen is recommended for children due to its safety profile and effectiveness in reducing pain and fever. Ibuprofen and aspirin can be used in children over 6 months old, but aspirin is not recommended for children due to the risk of Reye's syndrome. Diflunisal is not typically used in children. In summary, acetaminophen is the safest and most appropriate choice for a 5-year-old child's pain relief.
A nurse is providing discharge teaching for a patient who will be going home on cyclobenzaprine (Flexeril) prescribed for his acute musculoskeletal pain. The nurse will stress that the patient should avoid what?
- A. Taking antihistamines.
- B. Taking antiemetics.
- C. Taking antibiotics.
- D. Drinking alcohol.
Correct Answer: D
Rationale: The correct answer is D: Drinking alcohol. Cyclobenzaprine is a muscle relaxant that can cause drowsiness and dizziness. Alcohol can intensify these side effects, leading to impaired coordination and judgment. This can increase the risk of accidents and falls. It is important for the patient to avoid alcohol while taking cyclobenzaprine to prevent these adverse effects.
Choices A, B, and C are incorrect because there are no known interactions between cyclobenzaprine and antihistamines, antiemetics, or antibiotics that would pose a significant risk to the patient. It is essential to focus on the potential interactions that can have serious consequences, such as alcohol with cyclobenzaprine.